Laboratory

Biosafety
 TYPE OF SAFETY HAZARDS
Type Source Possible Injury
BIOLOGICAL Infectious agents Bacterial, fungal, viral, or parasitic
infections
SHARPS Needles, lancets, broken glass Cuts, punctures, or blood-borne
pathogen exposure
CHEMICAL Preservatives and reagents Exposure to toxic, carcinogenic,
or caustic agents
RADIOACTIVE Equipment and radioisotopes Radiation exposure

ELECTRICAL Ungrounded or wet equipment; Burns or shock

frayed cords
FIRE/EXPLOSIVE Bunsen burners, organic Burns or dismemberment
chemicals
PHYSICAL Wet floors, heavy boxes, patients Falls, sprains, or strains
Biological
Hazard
 Chain of Infection
-requires a continuous link between an infectious agent/pathogen, a reservoir, a portal of exit, a
means of transmission, a portal of entry and a susceptible host.
Components in the chain of infection are:
 Mode of Transmission
1. Direct contact: the unprotected host touches the patient, specimen, or a contaminated
object (reservoir)
2. Airborne: the host inhales dried aerosol particles circulating on air currents or attached to
dust particles
3. Droplet: the host inhales infected aerosol droplets from the reservoir (e.G., Aerosol
droplets from a patient or an uncapped centrifuge tube, or when specimens are aliquoted or
spilled)
4. Vehicle: the host ingests a contaminated substance (e.g., Food, water, specimen)
5. Vector: from an animal or insect bite

Hand sanitizing and adhering to standard precautions

(SP) are methods to break the chain of infection.
a means to enter the reservoir.
 Biological Safety
 Most direct contact with a source of infection in the clinical
laboratory is through contact with patient specimens
 Primary objective of biological safety- preventing
completion of the chain of infection
 Handwashing (at least 15-20 seconds/happy birthday song
2x) - SINGLE MOST EFFECTIVE WAY TO PREVENT THE
SPREAD OF INFECTIONS
 BIOHAZARD SYMBOL

- demonstrates how following prescribed safety practices can break the chain of
infection. This figure places particular emphasis on laboratory practices.
Which disinfectant inactivates
HBV and HIV?

A.Alcohol
B.Iodine
C.Phenol
D.Sodium hypochlorite
 D.Sodium hypochlorite
Diluted household bleach
Inactivates HBV in10 minutes
Inactivates HIV in 2 minutes
Disinfection of the sink using a 1:5 OR 1:10 DILUTION OF SODIUM HYPOCHLORITE should be PERFORMED
DAILY.
Sodium hypochlorite dilutions stored in plastic bottles are effective for 1 month if protected from light after
preparation.
The same solution also can be used for routinely disinfecting countertops and accidental spills.
Sharps
Hazard
Sharps Hazard -all sharp objects (needles, lancets, broken glassware) must be disposed of
in puncture-resistant containers.

Color of Container Designation

Dry non infectious

Black
Wet non infectious
Green
Wet infectious
Yellow
Sharps
Red
Chemical
Hazard
 Chemical Spills
 BEST FIRST AID is to flush the area with large amounts of
water for at least 15 minutes
 Contaminated clothing should be removed as soon as
possible.
 No attempt should be made to neutralize chemicals that
come in contact with the skin
 Chemical Handling
 Chemicals should never be mixed together unless specific
instructions are followed, and they must be added in the order
specified (l.e., acid should always be added to water)
 Wearing goggles and preparing reagents under a fume hood are
recommended safety precautions
 Pipetting by mouth is unacceptable in the laboratory
All chemicals and reagents containing hazardous ingredients in a concentration greater
than 1% are required by OSHA to have a Safety Data Sheet (SDS) on file in the workplace.

Information contained in an SDS 5. Methods for safe handling and

includes the disposal
following: 6. Primary routes of entry
1. Physical and chemical 7. Exposure limits and
characteristics carcinogenic potential
2. Fire and explosion potential
3. Reactivity potential
4. Health hazards and emergency
first aid procedures
 Chemical Labelling
NFPA (National Fire Protection
Association) Hazards Identification
System
• Diamond-shaped, color-coded symbol
contains information relating to health,
flammability, reactivity, and personal
protection/special precautions
∙ These symbols are placed on doors,
cabinets, and containers.
Position Color Indication

Left Health
Blue
Top Flammability
Red
Right Reactivity-Stability
Yellow
Bottom Special/Specific(Such as
White water reactivity, strong
oxidizer, corrosivity,
radioactivity)
Radioactive
Hazard
 Radioactive hazards
Radioactivity is encountered in the clinical laboratory when procedures using
radioisotopes are performed.

Exposure to radiation during pregnancy presents a danger to the fetus;

Electrical
Hazard
 Electrical hazards
 All electrical equipment must be grounded with
three-pronged plugs
 If electric shock accidents occur, never touch the
person or the equipment involved
 Turn off the circuit breaker/unplug the
equipment/move the equipment using a
nonconductive glass or wood object
 Fire
Hazard
 Fire/Explosive hazards
• When a fire is discovered, all
employees are expected to take the • The acronym PASS can be used to
actions in the acronym RACE: remember the steps in the operation:

Rescue—rescue anyone in immediate 1. Pull pin

danger 2. Aim at the base of the fire
Alarm—activate the institutional fire 3. Squeeze handles
alarm system
Contain—close all doors to potentially
4. Sweep nozzle side to side
affected areas
Extinguish/Evacuate—attempt to
extinguish the fire, if possible,
or evacuate, closing the door
Types of fires and fire extinguishers
Physical
Hazard
 Physical hazards
 General precautions to consider are to avoid running in
rooms and hallways, watch for wet floors, bend the knees
when lifting heavy objects, keep long hair pulled back,
avoid dangling jewelry, and maintain a clean, organized
work area.
 Closed-toe shoes that provide maximum support are
essential for safety and comfort.
 QUALITY ASSESSMENT
1. QUALITY MANAGEMENT SYSTEM (QMS)- refers to all the laboratories’
policies, processes, procedures, and resources needed to achieve quality
testing.

2. QUALITY CONTROL (QC)- a quality assessment program that includes

not only testing protocols but also pre-examination, examination and post
examination variables with proper documentation.
QC refers to the materials, procedures, and techniques that monitor the
accuracy, precision, and reliability of a laboratory test.
ACCURACY ability to obtain the expected result
PRECISION ability to obtain the same result on the same specimen of a test
RELIABILITY is the ability to maintain both precision and accuracy
 URINALYSIS PROCEDURE MANUAL
A procedure manual containing all the
procedures performed in the urinalysis section
must be available for reference in the working
area and must comply with the CLSI guidelines
 URINALYSIS PROCEDURE MANUAL
PRE EXAMINATION VARIABLE
Specimen collection and handling

EXAMINATION VARIABLE
❏Reagents
❏Instrumentation and Equipment
❏Testing procedure
❏Quality Control
 INTRUMENTATION AND EQUIPMENT
1. Refractometers 2. Osmometers

3. Automated reagent strip readers

 INTRUMENTATION AND EQUIPMENT
4. Centrifuge 5. Microscope
 QUALITY CONTROL
A. EXTERNAL QC Trend- gradual changing in the
• Used to verify the accuracy and mean in one direction
precision of a test. they are exposed to
the same conditions as the patient specimens. Shift- abrupt change in the mean
 QUALITY CONTROL
B. INTERNAL QC
Consists of internal monitoring systems built in to the system and are
called internal or procedural controls.
C. ELECTRONIC CONTROLS
Uses mechanical or electrical device in place of a liquid QC specimen.
This type of QC can be an internal or an external
component inserted into a point-of-care (POC) instrument.

D. PROFICIENCY TESTING (External Quality Assessment)

PT, or EQA, is the testing of unknown specimens received from an
outside agency and provides unbiased validation of the quality of patient
test results.
 URINALYSIS PROCEDURE MANUAL
POST EXAMINATION VARIABLE
 Written reports
 Electronic results
 Verbal results
 Result errors
 Critical results
 Interpreting results