Medical Laboratory Science Laboratory Safety Manual

Transcription

1 Medical Laboratory Science Laboratory Safety Manual Revised 7/14

2 TABLE OF CONTENTS SLS G-27 Lab...1 Introduction...1 Contact Information...2 MLS Program...2 MLS Faculty...2 Office of Environmental Health and Safety...2 MLS Student Safety Training Requirements...3 Universal Precautions and Bloodborne Disease...4 Universal Precautions...4 Major Bloodborne Diseases...4 HIV...4 HBV...4 HCV...4 Preventing Disease Transmission...5 Proper Hand Hygiene...5 Proper Use of Personal Protection Equipment...6 Safe Sharps Handling...6 Hepatitis B Immunization...7 Safety Aids and Equipment...8 Laboratory Vision Panel...8 Hazards and Emergency Sign...8 Fire Extinguisher...8 Drench Shower...8 Eyewash...9 First Aid Kit...9 Fume Hood...10 The Biological Safety Cabinet...10 Biological and Chemical Safety...11 Biological Safety...11 BSL-1 and BSL-2 Standards...11 Chemical Safety...13 Routes of Exposure...13 Regulated Exposure Limits...13 Chemical Use and Handling...14

3 Storage Waste Disposal Sharps Disposal Non-Sharps Disposal Burn Box Sanitary Sewer Disposal Chemical Waste Disposal Emergencies, Accidents and Spill Handling Emergency Contact Information Emergency Preparation Medical Consultation Accident and Injury Reporting Fire or Explosion Blood/Body Fluid Exposure Chemical Exposure Chemical Spill Biological Spill Hazard Communication and the Right to Know Hazard Identification Labels NFPA Hazardous Material Symbols Hazardous Classes and Associated Labels Material Safety Data Sheets Summary of MLS SLS G-27 Laboratory Work Practices Glossary Student Review of Safety Manual Signature Pages II

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5 SLS G-27 LAB Introduction The Medical Laboratory Science (MLS) program operates the student laboratory in Spaulding Life Sciences (SLS) room G-27 which is a BSL-2 (Biosafety Level 2) laboratory with the potential for individual risk associated with human disease transmission from blood and body fluids via percutaneous injury, ingestion, or mucous membrane exposure. A Laboratory Safety Plan has been established for the University of New Hampshire by the Office of Environmental Health and Safety (OEHS). The MLS program has also prepared this Laboratory Safety Manual with specifics for students participating in MLS courses in the SLS G-27 lab. The MLS Laboratory Safety Manual along with a copy of the UNH Laboratory Safety Plan is located in the MLS office in Kendall Hall room 210 and another copy of each is located in the SLS G-27 lab by the telephone. Each Medical Laboratory Science faculty member will point out and explain the use of all safety equipment in their respective MLS lab courses at the start of each semester. At the start of each lab, they will inform students of any additional safety requirements not previously covered. Please ask your course instructor should you have any uncertainties regarding safety procedures. There is a safe way to perform all laboratory work. The practice of safety in the MLS laboratory requires two important factors: The desire of the individual student for self-protection as well as concern for the protection of his or her fellow students The need to follow a set of laboratory work practices Safe laboratory practice is an attitude and requires the knowledge of potential hazards. Many accidents are the result of an indifferent attitude and a failure to use common sense and follow instructions. Students are expected to assist in maintaining a safe laboratory environment by observing the precautions stated in the UNH Laboratory Safety Plan and the MLS Laboratory Safety Manual and utilizing the information and protective measures as instructed. Additional UNH, CDC and OSHA safety information may be found in the appendices of this safety manual.

6 Contact Information Medical Laboratory Science Program: MLS Program Office: 210 Kendall Hall (603) MLS Program Laboratory: G27 Spaulding Life Science (603) Department Fax: 203 Kendall Hall (603) Website: MLS Faculty: Adele Marone, MS, MT(ASCP), MLS Program Director Office: Room 210 Kendall Hall, Joyce Stone, H(ASCP), SH, MLS Assistant Program Director Office: Room 217 Kendall Hall, Stephanie Clarke, MT(ASCP), Office: Room 216 Kendall Hall, Elise Sullivan, Ph.D, M(ASCP) Office: Room 285 Rudman Hall, Office of Environmental Health & Safety (OEHS) 11 Leavitt La., Perpetuity Hall Director, Bradford Manning: Biological Safety & Security Officer, Dana Buckley: EHS Coordinator Chemical Inventory, Ken Brown: Lab Safety Coordinator/Hazardous Materials Shipping Compliance, Andy Glode: Hazardous Waste Manager, Marty McCrone: Hazardous Waste Specialist, Jeff Anderson: Occupational Health & Safety Coordinator, Brian Cournoyer: Chemical Transfer Station Technician, Scott Pim: Administrative Assistant, Margie Houle:

7 MLS STUDENT SAFETY TRAINING REQUIREMENTS Faculty members are responsible for ensuring that their employees and students receive proper training as stipulated in the UNH Laboratory Safety Plan. MLS student training records are kept in the MLS office, Kendall 210. In order to participate in any Medical Laboratory Science (MLS) lab course or work in the MLS lab, students are required to complete the following: Read the MLS Safety Manual and document understanding by signing the MLS Safety Manual on the signature pages in appendix A Complete the required on-line Office of Environmental Health and Safety (OEHS) Training modules at least once per academic year Read and sign the MLS Safety Manual All students participating in MLS labs are required to read the main text pages up to appendix A of the MLS Safety Manual located in the MLS office in Kendall Hall room 210. The student should then sign the signature pages located in Appendix A for all MLS courses in which they are registered. This must be completed by the beginning of the third week of classes each semester. After the third week of classes, the student will be denied further participation in laboratory procedures until they have read and signed the MLS Safety Manual. Complete the required on-line OEHS Training modules In addition, all students must complete the Office of Environmental Health and Safety on-line BSL-1/BSL-2 Biological Safety AND the Bloodborne Pathogens training modules each fall semester or the spring semester should the student not have any fall semester MLS lab courses. MLS 659 (clinical chemistry lab) students must also complete the Chemical Safety Training module. Your course instructor will hand out the directions on how to access these modules on the first day of classes. Proof of completion of all on-line OEHS training must be printed out and submitted to an MLS course instructor by the beginning of the third week of classes. This will be kept on file in Kendall 210. After the third week of classes, the student will be denied further participation in laboratory procedures until they have submitted proof of completion. Students who complete the modules in the fall will not need to repeat the modules for Spring MLS courses 3

8 UNIVERSAL (STANDARD) PRECAUTIONS AND BLOODBORNE DISEASE Universal Precautions, as defined by CDC, are a set of precautions designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and other blood borne pathogens. Under universal precautions, blood and certain body fluids of all persons are considered potentially infectious. Universal Precautions Universal precautions apply to human blood, human blood components, any body fluid containing visible blood, products and reagents made from human blood, semen and vaginal secretions. Universal precautions also apply to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial and amniotic fluids. Universal Precautions does not apply to urine not visibly contaminated with blood however, Universal Precautions will be utilized when working with all urine specimens in the SLS G-27 lab. Major Bloodborne Diseases HIV HIV infection has been reported following exposures to HIV-infected blood through needlesticks or cuts; splashes in the eyes, nose, or mouth; and skin contact. Most often, however, infection occurs from needlestick injury or cuts. Risk of HIV infection after needlestick is 1 in 3000 or 0.3%. No vaccine currently exists to prevent HIV infection. HBV Hepatitis is an inflammation of the liver that can lead to liver damage and/or death. Hepatitis is much more transmissible than HIV. Risk of infection from a single needlestick is 6% - 30% (CDC, 1997). 50% of the people with HBV infection are unaware that they have the virus. The CDC states that HBV can survive for a least one week in dried blood on environmental surfaces or contaminated needles and instruments. Receiving a series of three hepatitis B vaccines will prevent HBV infection HCV HCV infection is the most common chronic bloodborne infection in the United States, affecting approximately 4 million people. The virus causes chronic liver disease and is the leading reason for liver transplants in the US. Hepatitis C infection is caused most commonly by needlestick injuries. HCV infection often occurs with no symptoms, but 4

9 chronic infection develops in 75% to 85% of patients, with 70% developing active liver disease (CDC 1998). No vaccine currently exists to prevent HCV infection. Preventing Disease Transmission Bloodborne disease transmission requires the agent to enter the recipient s general blood circulation. This can be through direct blood-to-blood (transfusions) or indirect (contaminated sharps) transmission. Less obvious routes of transmission are via the mucous membranes of the eye, nose or mouth or through breaks in the skin, which can be a result of simple dermatitis, acne, cuts, abrasions or hangnails. The following are the 4 major work practices used to prevent disease transmission (also see Biological Safety on pages 11 and 12). 1. Proper Use of Personal Protective Equipment (PPE) Appropriate use of PPE is mandatory in the SLS G-27 lab. PPE must be replaced as necessary. PPE penetrated by blood or other potentially infectious materials must be removed and replaced immediately. All PPE must be removed before leaving the laboratory area. The following PPE is used in the MLS lab to minimize student exposure to potentially infectious materials: Disposable gloves are worn for touching blood and body fluids requiring universal precautions, mucous membranes or non-intact skin of all persons and for handling items or surfaces soiled with blood or body fluids to which universal precautions apply. Disposable gloves are not to be washed or decontaminated for reuse. Gloves are to be replaced as soon as possible when they become contaminated or if they have become barrier compromised. Nitrile gloves are provided in the SLS G-27 lab. Safety goggles and splash shields are worn or used to prevent exposure of mucous membranes of the mouth, nose and eyes to potentially infectious material. They are used in combination whenever splashes, splatters, or droplets of potentially infectious material are reasonably anticipated. Splash shields are provided in the SLS G-27 lab. Students should purchase their own safety goggles with side shields. Disposable lab coats with sleeve cuffs must be worn during all procedures involving potentially infectious material or chemical reagents. Students must purchase a new blue disposable lab coat each year or upon visible contamination. Lab coats must be hung on the dirty side of the coat hanger at the front of the lab with at least one snap closed to prevent lab coat from falling on the floor. You will want to mark your lab coat in a very visible way so that you may quickly identify it as yours. 5

10 2. Proper Hand Hygiene Students must wash their hands immediately after removing gloves or other personal protective equipment and before exiting the lab. If accidental skin contamination should occur, the area should be washed with copious amounts of soap and water. Only the sink closest to the refrigerator in the SLS G-27 lab is to be used for hand washing. Thorough hand washing with soap and water is preferred over using an alcohol based-rub. Soap and water 1. Place hands under faucet. Water will automatically turn on. 2. Wet hands with water. 3. Dispense the foaming soap from the dispenser into the palm of one hand. 4. Rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers. 5. Rinse hands with water. 6. Dry thoroughly with paper towel. 7. Discard paper towel into regular trash receptacle. 8. If hands are overly dry the application of hand lotion or cream may minimize the occurrence of irritant contact dermatitis. Alcohol-based hand rub 1. Apply product to palm of one hand following the manufacturer s recommendation regarding the volume of product to use. 2. Rub hands together. 3. Continue rubbing hands together, covering all surfaces of hands and fingers, until hands are dry. 3. Safe Sharps Handling Sharps can be defined as any device having corners, edges or projections with the potential of cutting or piercing the skin. The following are examples of regulated sharps and must be disposed in sharps containers managed as medical waste, whether or not they are contaminated with biohazardous waste: needles, syringes, scalpels, razors. Contaminated needles and other contaminated sharps shall not be bent, recapped, or removed. Shearing or breaking of contaminated needles is forbidden. Contaminated sharps will be placed in appropriate containers immediately after use. 6

11 4. Hepatitis B Immunization The Hepatitis B Virus can cause severe damage to the liver and possible death. The primary exposure route to health care professionals is via percutaneous (skin) puncture by infected contaminated medical instruments (i.e. accidental needlestick). Exposure can also occur through contact with the eyes, mouth or broken skin. According to the Center for Disease Control (1997) 6% - 30% of percutaneous exposures result in infection with the Hepatitis B Virus. The most effective means of preventing Hepatitis B infection is through vaccination. All MLS students are strongly urged to receive a series of three Hepatitis B Virus immunizations. All three doses of the vaccine are required to confer immunity. The second dose is administered at 30 days after the initial dose, and the third dose is administered at 180 days from the initial dose. If you are uncertain as to whether you have received HBV immunizations as a child, consult with your physician. If you have not already received HBV immunizations you should begin the series as soon as possible. The initial immunization should be received prior to the start of any MLS course (excluding MLS 401). Student Health Services at the University of New Hampshire offer the immunizations at cost (approximately $75.00 each) to UNH students that have paid the student health fee. The HBV form, located in Appendix B, should be returned to your Medical Laboratory Science advisor or program director and will be kept in your file in the Medical Laboratory Science program office. In order to comply with Medical Laboratory Program policy, a student that chooses not to receive the vaccine must sign a Hepatitis B Vaccine Declination Statement form, also located in Appendix B, which releases UNH from liability. However, students that do not receive the Hepatitis B Vaccination series will not be eligible for Medical Laboratory Science clinical internships that require HBV immunization. 7

12 SAFETY AIDS AND EQUIPMENT Laboratory Vision Panel The laboratory vision panel is the window space in the main door of the laboratory, used by emergency response personnel to identify internal problems. The Durham Fire Department requests that the vision panel in the door not be blocked. Hazard and Emergency Sign A hazard and emergency information sign is posted on the laboratory wall just outside the door facing the corridor. This sign is used by emergency response personnel. The sign identifies the hazards within the lab, the responsible faculty member, and other persons to be contacted in the event of an emergency. In the event of an accident, chemical spill, fire, or personal injury, assistance from a person familiar with the laboratory may be requested. A faculty member reviews the signs at least annually or in the event that pertinent information changes. Fire Extinguisher An ABC type extinguisher is located at the front of the room by the door closest to the Biological Safety Cabinet. The Durham Fire Department requires training before using a fire extinguisher. For more information on fire extinguishers, contact OEHS. Drench Shower The drench shower is located in the ceiling just inside the door closest to the Rudman Hall underpass. The shower is used when a person is covered with potentially harmful or corrosive material. At least three feet of space in each direction is required beneath the shower and this area must be kept free of all obstacles. Facilities Services inspects drench showers annually for proper flow and operation. A DO NOT USE notice is placed on the unit if the shower is not properly functioning. 8

13 The Drench Shower Procedure: The person must stand under the nozzle and pull the cord. The water must be forceful enough to soak the person within a few seconds. The wash must run for a minimum of 15 minutes and the water must be cold. During the shower the person must remove all contaminated clothes, even down to their underwear. Be aware that the room does not have a drain and that electrical or slipping hazards may be generated. After the wash ends, the person might need to be treated for hypothermia. Seek medical attention as soon as possible. Provide MSDS sheet when possible. An accident report must be filled out. Eye Wash The eye wash is located directly ahead of the door closest to the Rudman Hall underpass and another is located at the handwashing sink. The best treatment for hazardous agents in the eye and face is immediate flushing with copious amounts of water for 15 minutes. These include blood, body fluids, chemicals, and reagents. All plumbed eye and face washes should be flushed on a weekly basis by allowing the water to flow for approximately 3 minutes to remove stagnant water from the pipes. Plastic eye wash bottles are not recommended. The Eye Wash Procedure: Move victim from spill area only if attempts to move victim does not endanger victim and yourself. Lead victim to the eye wash station and immediately begin the water wash. Holding the eye open flush the eye continuously for at least 15 minutes or longer if pain persists. Seek medical attention as soon as possible. Call 911 for hazardous chemical eye splashes and attempt to provide emergency workers with MSDS. An accident report must be filled out. First Aid Kit Located in cabinet underneath the fume hood. The first aid kit includes disposable gloves, adhesive bandages, sterile pads, adhesive tape and ice packs (but not topical creams or ointments). 9

14 Fume Hood General room ventilation does not provide adequate protection against hazardous gases, vapors, and aerosols. Fume hoods are designed to minimize exposure to hazardous chemicals. They are the primary means of protection against the inhalation of hazardous vapors. All work with corrosive, flammable, odoriferous, toxic, or other dangerous materials shall be conducted only the chemical fume hood. The fume hood is checked annually by OEHS. The velocity of the air at the face of the hood is measured (with the sash half open) and posted on the upper right-hand corner. If the fume hood does not meet the minimum exhaust requirements during inspection a DO NOT USE note is posted and Facilities Maintenance is notified about the need for repairs. Once repairs have been made, OEHS will re-test the fume hood for proper operation. Fume hood operation: Ensure that air is entering the unit. Ensure the baffle openings are not blocked and air is flowing properly. Conduct work at least six inches from the edge. Lower the sash to protect yourself from dangerous reactions. Keep hood clean and uncluttered and wipe up spills immediately. Be aware that drafts from open windows and doors, fans, air conditioners, or high traffic walkways may interfere with normal hood exhaust. Conserve energy by keeping the sash closed when not in use. The Biological Safety Cabinet (BSC) The class II (vertical laminar flow) biological safety cabinet (BSC) provides a partial containment system for the safe handling of pathogenic microorganisms. To ensure safety, the BSC must be used correctly with good microbiological techniques and be in proper mechanical working order. The cabinet must be certified for performance annually. The University maintains a contract with a company to service and to certify BSCs. Biological safety cabinet operation: It should be decontaminated with 10% bleach after work is complete. Gas lines, open flames and volatile or toxic chemicals are prohibited inside. 10

15 BIOLOGICAL AND CHEMICAL SAFETY Biological Safety Biological safety is the recognition, evaluation and control of biological health risks. The Centers for Disease Control (CDC) and National Institutes for Health (NIH) recommend that Biological Safety Level Two (BSL-2) standards, containment, and facilities be used for activities involving clinical specimens and body fluids from humans as well as serum-derived reagents which may be used as controls. Therefore the SLS G-27 laboratory follows BSL-2 standards. BSL-2 labs have the potential for exposure to pathogens that may cause human disease. Routes of exposure are injection (percutaneous), ingestion, and absorption via mucous membranes. Most work may be done on the open bench when using the appropriate PPE. BSL-2 standards include BSL-1 standards plus additional BSL-2 standards. BSL-1 and BSL-2 Standards: Universal precautions are followed whenever there is potential for exposure to blood, body fluids, or human serum-derived controls and reagents. Properly maintained Biological Safety Cabinet (BSC), or other appropriate PPE or physical containment devices are used whenever procedures with a potential for creating infectious aerosols or splashes are conducted. These may include centrifuging, vigorous shaking or mixing, and opening containers of potentially infectious materials whose internal pressures may be different from ambient pressures. Exposure is limited through the use of Personal Protective Equipment (PPE) including lab coats, gloves, and face protection (goggles, face shields) as needed. Closed shoes must be worn (no open-toed shoes, flip-flops, sandals, or clogs) Blue disposable protective laboratory coats designated for lab use are worn. These are purchased at the Chemistry Stockroom in Parsons Hall. Lab coats are removed and left in the laboratory before leaving for nonlaboratory areas. All lab coats are discarded at the end of each year by MLS faculty. A new lab one must be purchased each year or when the lab coat becomes visibly soiled with blood or body fluids. Lab coats are never taken home. Face protection (goggles, mask, face shield or other splatter guard) is used for splashes or sprays of potentially infectious materials. Gloves are worn when the hands may contact potentially infectious materials 11

16 Gloves are discarded when they become visibly contaminated or when the integrity of the glove is compromised. Gloves are not washed, reused, or used for touching clean surfaces (keyboards, telephones, door handles, sink faucets) and they should not be worn outside the lab. Hands are washed following removal of gloves and before leaving the laboratory. Specimens of body fluids or other potentially infectious materials are disposed of in a container with a cover that prevents leakage during collection, handling, processing, storage, transport, or shipping. See Waste Disposal and Safe Sharps Handling sections. A high degree of precaution must always be taken with any contaminated sharp items, including needles, slides, pipettes and capillary tubes. See Safe Sharps Handling section. Laboratory equipment and work surfaces must be decontaminated with 10% bleach solution on a routine basis, after work with potentially infectious material is finished, and especially after spills, splashes, or other contamination by potentially infectious materials. Eating, drinking, smoking, handling contact lenses, applying cosmetics and storing food for human use or disposing of food waste are not permitted in the laboratory. Mouth pipetting is prohibited. Access to the laboratory is limited or restricted by the faculty member in charge when work with potentially infectious agents is in progress. Only individuals advised of the potential hazards and meeting specific entry requirements (e.g. immunization) may enter the laboratory. Students are advised of special hazards and are required to read and follow instructions on practices and procedures. Students must be advised regarding immunizations (e.g. hepatitis B vaccine) or procedures to follow in the event of accidental percutaneous exposure to bloodborne pathogens. Students receive training on the potential hazards associated with the work involved and precautions to prevent exposures. Students receive annual updates or additional training as necessary for procedural or policy changes. See previous Training section. Spills and accidents that result in exposures to potentially infectious materials are immediately reported to the faculty member in charge. Medical evaluation, surveillance, and treatment are provided and written records are maintained. See Biological Spills section. 12

17 Chemical Safety A hazardous chemical is defined as and chemical that poses a health or physical threat. A chemical is considered to pose a health hazard if it has been documented to cause some type of adverse health effect in an exposed individual. Therefore, it is crucial to plan ahead of time and to substitute less hazardous chemicals when at all possible. A Particularly Hazardous Chemical (PHC) is a chemical that poses particular health hazards (including both acute and chronic effects) or physical hazards (such as flammability or the potential for explosions) and requires special handling. Routes of exposure, regulated exposure limits and target organ effects must be considered when handling PHCs. Routes of Exposure There are four ways that hazardous chemicals may enter your body: Inhalation entry into the lungs or nasal tubes is the most common route. Absorption entry via the skin through the epidermal cells, sweat and sebaceous glands, hair follicles, and eyes. Injection - Injection directly into the body (i.e. needle stick) Ingestion Accidentally or purposefully eating a hazardous chemical. Usually caused when hands are not washed properly. Regulated Exposure Limits A Permissible Exposure Limit (PEL) is the maximum amount or concentration of a chemical that an individual may be exposed to under OSHA regulations. The PEL determines the amount of a PHC to which you may be exposed and not experience any side effects. It is possible to have an exposure to a chemical without knowing it. For example, an evaporated compound may be present in the air and inhaled by unsuspecting individuals. A Short Term Exposure Limit (STEL) should not exceed 15 minutes at any time. These limits should be taken into account while working with any hazardous chemical. 13

18 Chemical Use and Handling MSDS contain detailed information regarding the proper use, handling and disposal of chemicals. UNH must have a MSDS for each chemical present and individuals must have easy access to the MSDS and be trained in how to read and understand MSDS. See MSDS section in this manual for more information MSDS are available online through the Chemical Environmental Management System Contact Ken Brown or Andy Glode in EHS for CEMS training. Storage The number and amount of chemical stored should be reduced to an absolute minimum. Chemicals should be stored according to their compatibility (not alphabetical order). Acids, flammable liquids, oxidizers and highly reactive chemicals should all be separated and stored properly to avoid an unwanted chemical reaction. Please refer to the OEHS Table of Incompatible Chemicals. The following are general guidelines: Storage areas should be well ventilated Large containers should be stored on low shelving, preferably in tray to contain all leaks and spills. Chemicals should not be stored on the floor, on bench tops or inside fume hoods. Odiferous chemicals should be stored inside vented cabinets or fume hoods. Flammables requiring refrigeration should be stored in explosion safe refrigerators Inventories of storage areas should be conducted on an ongoing basis and results should be posted on the UNH CEMS website at 14

19 WASTE DISPOSAL Sharp Disposal There are three classes of sharps waste produced at UNH. This information complies with OSHA s Bloodborne Pathogen Standard (29 CFR ) and federal, state, and local waste disposal guidelines. The disposal procedures for these classes are as follows. Class 1: Non-chemically contaminated broken glass and non-biologically contaminated broken glass. This class consists of any type of glass that has been rinsed of any chemical contamination, including: solvent bottles, chemical bottles, test tubes, broken flasks. Procedure for disposal: 1. Place all non-contaminated glass in a sturdy, leak proof, puncture-resistant broken glass box. Pictured below is an approved broken glass box. 2. Tape box closed when it is full. 3. Laboratory personnel should place the box directly into a dumpster. Broken Glass Container Used for: any glassware that has not been contaminated with any blood and/or body fluids. Ex. Glass or sharp object with non-biological reagents, clean slides, test tubes, disposable glass pipettes. Class 2: Chemically contaminated broken glass This class consists of broken glass that is contaminated with a P listed waste. Contact the Hazardous Waster Coordinator at to determine if a chemical is on the P list. Glass contaminated with non-listed waste can be place in a broken glass box. 15

20 Procedure for disposal: 1. Place waste in a puncture proof container. 2. Label with a completed UNH Hazardous Waste label. 3. Call the Hazards Waste Coordinator at to schedule a pickup. Class 3: Biologically contaminated sharps This class consists of: all biologically contaminated sharps from BSL-1, BSL-2, or BSL-3 laboratories AND all syringes and needles, whether they are biologically contaminated or not. Procedure for disposal: Place all biologically contaminated sharps (test tubes, vacutainer tubes, glass slides and hard plastic pipette tips) as well as all syringes, needles, razors and scalpels, whether they are contaminated or not, into a sharps container. Sharps containers must be red, leak proof, puncture-resistant, and labeled with the biohazard symbol or the word Biohazard. See pictures of approved sharps containers below. When sharps containers are filled to the marked line on the container (approximately ¾ full) they are securely closed and placed in the biohazard burn box. General Sharps Disposal Guidelines Never overfill sharps containers. Close the lid on sharps containers when they reach the fill line (approx. 3/4 full). Place the sharps container in the infectious agent burn box. Never re-use sharps containers. 16

21 Non-Sharp Disposal Biohazardous Waste Any non-sharp waste (see examples below) which has the possibility of being contaminated with blood and/or body fluids should be disposed of in the orange plastic biohazard bags that are placed in covered white plastic containers around the lab. The lids to these containers should be in place at all times except when waste is being added (see picture below). When bags are full they are removed from containers, securely taped closed with clear packing tape and placed in the biohazard burn box. Plastic Biohazard Bags (in covered white container) Ex. All used gloves, paper towels used to clean spills or to wipe down benches with 10% bleach, gauze, plastic urisystem slides, soft plastic Pasteur pipettes, plastic conical tubes, plastic micro-tubes, and other biohazardous material incapable of puncturing plastic bag etc. Non-Biohazardous Waste (excluding sharps) Paper or plastic trash that has not been contaminated with blood and/or body fluids may be disposed of in the regular trash receptacles Ex. Paper towels used to dry your hands, tissues to clean slides, paper. *If there is question about whether trash is contaminated, it should be treated as if it is contaminated. Gloves should never be placed in the normal trash. Burn Box The plastic sharps containers and the plastic biohazard bags are placed into the 4.5 foot cardboard burn box (see picture below) contained in the large base cabinet adjacent to the eye wash. This box is double lined with biohazardous red bags to assure that no leakage will occur. Procedure for Disposal 1. When box is full (< 50 lbs) twist each red bag separately and seal each with clear packing tape. 2. Secure the box top. 3. Seal it with clear packing tape. 4. Label it with the building, room number, and name. 4. Call the Hazardous Waste coordinator at to schedule a pick up. 17

22 Sanitary Sewer Disposal Body fluids to which Universal Precautions do not apply (i.e. urine not visibly contaminated with blood) may be disposed of down the staining sink (closest to the back windows) only. Never use the hand washing or glassware washing sinks for fluid disposal and never use the disposal sink for hand washing. The following procedure is to be followed: Wear facial protection, gloves, and laboratory coats. Hold the sample tube or cup as close to the sink drain as possible. Avoid splashes while decanting material gently into sink drain. Do not run water while decanting. Follow with copious amounts of water. Decontaminate sink with 10% bleach. Chemical Waste Disposal Each laboratory must follow the procedures specified in the UNH Hazardous Waste Management Plan (mandated by the Office of Environmental Health and Safety or OEHS). This document is available on the OEHS website at Proper disposal and storage requirements are applicable for all hazardous waste materials: Labeling: The label must contain the information shown on the provided hazardous waste labels and be completely filled out Packaging: The chemical waste container must have a cap in place at all times (except when filling or discharging the bottle). Place the primary, chemical container into a secondary container for additional protection. Storage: The chemical waste must be stored in a location specifically for Hazardous Waste. Hazardous waste that is not properly packaged and labeled cannot be removed by OEHS For waste pickup, you can either use the Chemical Environmental Management System (CEMS) or call the appropriate numbers on campus. 18

23 EMERGENCIES AND ACCIDENTS In all emergencies and accidents, the first consideration is your safety and the safety of those around you. The accident victim should be monitored closely in the minutes following an accident for dizziness and/or fainting. Emergency Contact Information: Dial 911 to request emergency assistance on campus (fire, police or ambulance). Office of Environmental Health and Safety (OEHS): Health Services Center: See the UNH Laboratory Safety Plan for more information. Emergency Preparation In order to be prepared for an emergency, know the hazards and assess the risks associated with any hazardous agent. The following criteria must be considered: Toxicity, reactivity, and flammability of the compound. The amounts involved. The duration of exposure. Potential routes of entry (inhalation, ingestion, or skin contact). Medical Consultation Serious injuries must be reported to the University Police (911). All other injuries should be assessed by UNH Health Services or your personal medical care provider. A medical provider should also be consulted when: An employee or student develops signs and symptoms of exposure. An event takes place resulting in the likelihood of an exposure. Exposure monitoring is above OSHA action level. There are special concerns about chemicals such as reproductive toxins. Accident and Injury Reporting The Department of Medical Laboratory Science requires that any accident/injury occurring in the laboratory in Spaulding G27 using the following protocol: 1. All accidents and injuries should be reported to the faculty supervisor. 2. Serious injuries that require an ambulance must be reported to the University Police Department at 911 immediately. 19

24 3. All other injuries should be assessed by a medical care provider either the UNH Health Services Center ( ) or your own medical care provider. Paper work to be completed: 1. In the event of a laboratory accident, fire, explosion, chemical, biological, or radiological spill, regardless of whether an injury has occurred, the person affected by the incident, a witness, or the laboratory supervisor must complete the Laboratory Accident Report Form is located at A sample is located in appendix D. 2. If the accident or injury involves blood/body fluid exposure, in addition to the Laboratory Accident Report form, the Blood and Body Fluid Exposure Report Form must also be completed and turned in to the MLS office. A copy of this form is located in appendix D. Additional copies are located in the forms drawer in the MLS office. The Biosafety Officer, Dana Buckley, must also be notified ( ) 3. If an injury or work related illness involves a UNH employee (paid by the University System of New Hampshire) they must also complete the UNH Report of Injury/Occupational Illness Workers Compensation form located at A copy of this form is located in appendix D. This report must also be faxed to: a. Brian Cournoyer, Occupational Health and Safety Officer, Fax # b. Mariah Bellington, Human Resources, Workers Compensation Coordinator, Fax # Fire or Explosion In the event of a fire or explosion: Evacuate the fire area immediately. Close the door to the fire area. Pull the fire alarm. (One is located directly across the hall from the lab). Evacuate and stay clear of the building. Dial 911 from a safe location and report the exact location of the fire. Do not attempt to extinguish a fire unless: o You have been trained to do so. o You are aware of the hazards in the area. o You have warned others of the fire (or activated the alarm). Complete the Laboratory Accident Report form (see above). 20

25 Blood/Body Fluid Exposure In the event of a parenteral (needle stick/sharps injury), eye, mouth, mucous membrane, cutaneous exposure to non-intact skin, or cutaneous exposure to intact skin involving large amounts of blood immediately provide the following care: Intact skin clean skin surface immediately and thoroughly as defined in the hand washing section. Puncture, laceration, or non-intact skin gently cleanse wound with antiseptic soap and water for 5 minutes. Eye remove contact lens (if worn) and irrigate with water for 15 minutes. Mucous membrane rinse thoroughly with water. Report to Health Services or Hospital Emergency Room within one hour. Complete the Laboratory Accident Form. Complete the Blood and Body Fluid Exposure Report Form. Inform, Dana Buckley, Biological Safety and Security Officer Chemical Exposure In the event of exposure to hazardous chemical(s) immediately: Flush the area with copious amounts of water for 15 minutes. If the area is small the sink may be used for flushing. If the area is large the drench shower may be necessary. If the eyes have been exposed the eyewash should be used. Assess the chemical hazard and dial 911 or report to Health Services as indicated. Complete a Laboratory Accident Form. The following information should be provided to medical personnel: Identity of the chemical(s). Conditions under which exposures occurred. Signs and symptoms of exposure. Whenever possible, a MSDS should be provided. 21

26 Spill Clean-up A spill is defined as a material out of control. Some spills may be cleaned-up by laboratory personnel (minor spills) while other spills require the assistance of spill response personnel (major spills). All spills greater than 1 quart (1 liter), regardless of substance, must be reported to OEHS at or 911. One issue to consider is whether the hazards, the location, and the quantity of the spill cause the situation to be beyond the capabilities of the lab personnel. Before attempting to clean up a spill, the lab responder must put on a minimum amount of personal protective equipment (PPE). Safety Glasses Lab Coat Nitrile or neoprene gloves Chemical Spills If you understand the properties of the chemical and know it to be a minimal hazard and the amount spilled is small, clean it up. Alert all persons nearby and evacuate the area (if necessary). If a towel is used to clean up the spill, it should be placed in the fume hood because it may contain or release volatile chemicals. A stain spill will stain anything; therefore gloves should be worn. The towel used to clean up the spill may be disposed of in the normal trash container. Properly package and label as hazardous waste. Complete this step only if it is safe to do so. If you do not understand the properties of the chemical, know it to be hazardous or the amount spilled is large: Avoid breathing vapors of the spilled material. If flammables are spilled and your safety is assured, turn off any ignition devices. Evacuate the area and close the door to the laboratory. Immediately notify your supervisor of the incident. During regular work hours, contact OEHS at On weekends, holidays and after 5 pm, contact UNH Police at 911. Be prepared to provide the identity, amount and location of the spill, as well as your location and a phone number where you can be reached. See the UNH Laboratory Safety Plan for more information. 22

27 Biological Spills The procedures to deal with biological spills vary depending on the agent, quantity, and location of the event. However, in order to quickly clean-up a biological spill, your laboratory should keep a spill kit handy. A spill kit should include: Concentrated disinfectant (chlorine bleach or Lysol) Packages of paper towels Forceps to pick up broken glass Rubber gloves Biohazard bags Small spill of BSL-1 or BSL-2 material outside of a safety cabinet (<500 ml spill and able to be covered by a few paper towels) Only clean up the spill if it is small enough and you feel it is safe. Notify supervisor of spill. Wearing gloves and a lab coat, surround the spill with paper towels ro prevent further spreading. Cover the spill with paper towels and pour an appropriate disinfectant (1:10 bleach solution) over the spill. Allow sufficient contact time with disinfectant (usually > 20 minutes). Pick up towels and discard into biohazard waste container. Pick up broken glass with forceps or tongs and place in Sharps container. Re-wipe the spill area with disinfectant. Remove gloves and dispose of in Biohazardous Waste containers. Wash your hands with soap and water (see Proper Hand Hygiene ). Large spill of BSL-1 or BSL-2 material outside of a safety cabinet (>500 ml) GET HELP! (Call ) Notify the supervisor See the UNH Laboratory Safety Plan for more information. 23

28 HAZARD COMMUNICATION AND THE RIGHT TO KNOW The Occupational Safety and Health Administration s (OSHA) Hazard Communication Standard (HCS) mandates that everyone has a need and a Right-to-Know the identity of chemicals they are exposed to and the hazards associated with these chemicals. The HCS covers both physical hazards (such as flammability or the potential for explosions), and health hazards (including both acute and chronic effects). The HCS is a law that is meant to protect you. There are five main elements to this standard: Written Hazard Communication Plan Hazard Identification Hazardous Materials Labeling System Material Safety Data Sheets (MSDS) Training and Record keeping The Hazard Communication Plan will help you to: Locate information about the chemicals used in your work area Assess the hazards of the chemicals you work with Recognize the effects of chemical exposure Take appropriate protective measures to minimize your contact with chemicals Hazard Identification Chemical Hazards See sections on Chemical Safety and MSDS for more information Physical and Fire/Explosive Hazards Flammables (Class I Liquids) Combustibles (Class II and Class III Liquids) Compressed Gasses (Gas Cylinders) Reactives (Explosives and Oxidizers) See Section on Chemical Safety for more information 24

29 Labels Labels are required by OSHA and provide an immediate warning of the hazards to which you may be exposed in working with certain chemicals. All labels must include: The identity (common, trade or chemical name) of the hazardous chemical Appropriate hazard warnings o target organ or site of effects o health, flammability and reactivity warnings The product manufacturer or distributor name and address. Types of hazardous ingredients include: Carcinogens Hepatotoxins/Nephrotoxins/Neurotoxins Reproductive Toxins Irritants/Corrosives Hazardous ingredients in a chemical must be listed if it makes up greater than 1% of the entire chemical (OSHA s 1% rule). There is one exception to this rule: ALL CARCINOGENS MUST BE LISTED EVEN IF ONLY 0.1% National Fire Protection Association (NFPA) Hazardous Material Symbols Blue = Health Red = Fire/Flammability Yellow = Reactivity White = Special Hazard Information Hazard scale: 0 4 (least to most hazardous) 25

30 HAZARD CLASSES AND ASSOCIATED LABELS 26

31 27

32 Material Safety Data Sheets (MSDS) Material Safety Data Sheets (MSDS) are required and UNH has an MSDS for the chemical present on campus. MSDS contain information regarding the proper use and handling of chemicals. MSDS are available online through the Chemical Environmental Management System (UNHCEMS) at Contact Ken Brown or Andy Glode for UNHCEMS training or more information. Section 1 Section 2 Section 3 Section 4 Section 5 Section 6 Section 7 Section 8 Section 9 Section 10 Section 11 Section 12 Section 13 Section 14 Section 15 Section 16 Chemical Identification Composition / Information on Ingredients Hazards Identification First Aid Measures Fire-Fighting Measures Accidental Release Measures Handling and Storage Exposure Controls / Personal Protection Physical and Chemical Properties Stability and Reactivity Toxicological Information Ecological Information Disposal Considerations Transport Information Regulatory Information Other Information 28

33 SUMMARY OF SLS G-27 LABORATORY WORK PRACTICES Student work practices required in the SLS G-27 lab include: Completing health and safety training requirements prior to the beginning of the third week of classes as described on page 3 of the MLS Safety Manual. Purchasing a disposable blue lab coat with cuffs for your own individual use at the beginning of each semester. Purchasing lab safety goggles with side shields. Knowing the location of the UNH Laboratory Safety Plan and the MLS Safety Manual in the lab. Knowing the location of all lab safety equipment and supplies. Following all safety and health procedures specified in the UNH Laboratory Safety Plan, the MLS Safety Manual, and as instructed by the faculty supervisor in the lab. Observing hazard signs at the entrance(s) to the lab. Observing the no eating, drinking, applying cosmetics, or removing or inserting contact lenses lab policy. Observing the no food allowed and no disposing of food waste or food containers in the lab policy. Placing all backpacks, coats, jackets, pocketbooks and other personal items on the clean side of the coat rack or on top of the coat rack at the front of the lab. Observing universal precautions by considering all human body fluids infectious and handling and transporting them appropriately. Wearing Personal Protective Equipment (PPE) including lab coats, gloves, and face protection (goggles, face shields) when working with blood or other potentially infectious material (OPIM). Never expose large amounts of skin. Wearing closed shoes (no open-toed shoes, flip-flops, sandals, or clogs allowed). Wearing gloves when touching mucous membranes, or non-intact skin or when handling items or surfaces contaminated with blood or bodily fluids. Wearing gloves while performing venipuncture. Wearing protective eyewear and using face shields during procedures that are likely to generate splashes or aerosols of blood or other bodily fluids in order to prevent exposures of the mucous membranes of the mouth, nose, and eyes. Changing gloves between each venipuncture procedure. Changing gloves upon visible contamination or if they are torn, punctured or their ability to function as a protective barrier is compromised in any way. Washing hands and other skin surfaces immediately and thoroughly with water and soap if contaminated with blood or other bodily fluids. 29

34 Observing Sharps precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during or after procedures, when cleaning instruments, and during disposal of used needles. Never recapping or purposely bending or breaking needles, or removing needles from disposable syringes/needle holders or otherwise manipulating needles by hand. Disposing of all sharps including syringes, needles, scalpel blades, and other sharp items in puncture-resistant sharps containers for disposal. Placing sharps containers as close as practical to the area where disposable sharps are used. Never mouth pipetting. Labeling all containers and tubes appropriately. Knowing the potential hazards of the materials you are working with. Referring to the written laboratory procedures and understanding the health and safety hazards associated with each procedure. Reviewing the Material Safety Data Sheets (MSDS) for all chemicals used. Using the fume hood when working with hazardous chemicals or volatile reagents. Closing lab doors when working with infectious material. Never working alone with potentially infectious material, hazardous chemicals, or dangerous equipment. Prohibiting unauthorized/untrained individuals in the lab when working with potentially infectious material, hazardous chemicals, or dangerous equipment. Keeping work areas clean and uncluttered at all times. Disposing of all non-sharp biological waste in red biohazard waste bags and keeping the bag containers covered when not in use. Disposing of all chemicals in properly labeled hazardous waste containers. Decontaminating laboratory work surfaces with 10% bleach after a spill of blood or other bodily fluids and when lab activities are completed. Removing gloves before touching door handles, sink faucets, computer keyboards, telephones and other clean items in the lab. Removing all PPE before exiting lab. Hanging lab coats with at least the top snap closed on the dirty side of the coat rack at the front of the room and placing a pen designated for laboratory use only in the pocket. Washing hands immediately after removing gloves. Washing hands before leaving the lab. Reporting all accidents and unhealthy or unsafe conditions to the faculty supervisor as soon as possible. 30