Articles
Integrating Safety in Science—How to Get Scientists’ Buy-in
Viji Vijayan*, Mahalakshmi R N, and Meng Chuan Lee
Duke-NUS Graduate Medical School, Singapore
Abstract
Universities have Occupational Health and Safety Offices
where safety professionals ensure compliance with regulations
through the establishment of policies, procedures, and instruc-
tions. This traditional approach is being replaced by a more
proactive system-based, comprehensive, business manage-
ment approach known as a Safety Management System (SMS).
The Duke-NUS (National University of Singapore) Graduate
Medical School, has implemented an SMS for every research
laboratory under a Scheme called the Laboratory Safety &
Health Management System Certification Scheme.
Introduction
Most universities have Occupational Health and Safety
Offices that are established to protect the health, safety, and
welfare of people engaged in the activities of the universi-
ty. The Office engages safety professionals from multiple
disciplines who draw up polices, develop programs, and
establish essential training and standard operating proce-
dures (SOPs) required to meet this goal and to maintain
compliance with applicable regulations.
The conventional method adopted by safety profes-
sionals is to provide specific directions so that workers
comply with the required safety standards and regulations.
The safety professionals stay aware of new regulations and
changes to existing regulations, and enforce these regula-
tions to ensure that staff and students adhere to them.
In addition, they carry out inspections and audits, report
and investigate accidents and injuries, and determine what
measures need to be taken to prevent accidents and injuries
in the future. Herrero et al. (2002) argues that this tradition-
al, prescriptive, top-down approach is based on established
rules, regulations, and safety instructions, the mere publica-
tion of which in a safety manual is insufficient for effective
implementation. He writes that taking a proactive approach
produces better results than analyzing accidents after they
happen and then using that data to plan improvements.
A system-based approach is proactive and more effec-
tive than one that continually analyzes accidents after they
happen and generates data on which to base improvements.
Safety Management System (SMS) is a term that refers to
such a system-based, comprehensive, business management
system designed to manage occupational health and safety
(OH&S) in the workplace. It is important that an SMS is
woven into the fabric of an organization and that it be-
comes part of the culture permeating the way people do
their jobs (Transport Canada, 2006).
172 www.absa.org Applied Biosafety
Research has identified that management commitment
to OH&S, combined with employee involvement, are key
drivers in accomplishing a safety culture in the workplace
(Shaw, 1996). Furthermore, according to Granerud and
Rocha (2011), the SMS approach is a means for employers
to handle challenges and reduce haphazard attitudes toward
risks and problems in the work environment. Establishing
an SMS makes it possible for organizations to adopt specif-
ic standards for safe working conditions and demonstrate to
stakeholders, both external and internal (employees), how
they are living up to those standards. Both ISO 9001 and
later standards in other fields are characterized by the es-
tablishment of internal systems of regulation and control
within companies, systems that can be certified and audited
by external auditing agents (Hohnen & Hasle, 2011).
The well-established and widespread use of SMS can
be seen in industries such as aviation, oil, and petrochemi-
cals (Pearse, 2001). However, in the field of biomedical/
clinical sciences, especially in academia, this approach is
only now gaining traction as an accepted approach to man-
aging occupational health and safety.
In Singapore, the Workplace Safety and Health Act
(Risk Management) Regulations, enforced by the Ministry
of Manpower, came into effect in September 2006. Under
these regulations, all workplaces must establish an OH&S
management system to ensure that the health and safety
risks in the workplace are effectively managed (Singapore
Attorney-General’s Chamber, 2013).
The National University of Singapore (NUS), in-line
with this Act, implemented a system called the Laboratory
Safety & Health Management System Certification Scheme
(Scheme) in which Principal Investigators (PIs) of research
laboratories were required to develop and implement a la-
boratory SMS. NUS also developed the Laboratory Occu-
pational Safety & Health Management Standard for this
scheme to provide the PIs with a framework for managing
occupational health and safety within their laboratories.
The framework consisted of 16 elements (Table 1) modeled
after the Occupation Health and Safety Assessment Series
(OHSAS) 18001 standards. The Deming’s Plan-Do-Check-
Act cycle (Bushell, 1992) was the main propellant for ef-
fectively implementing, reviewing, and continuously im-
proving the SMS.
PIs who successfully demonstrated the effectiveness of
their SMS were enrolled in the Certification Scheme and
provided with a certificate valid for 3 years by the universi-
ty’s Safety Office. During this period, an annual surveillance
audit was conducted to ensure that the SMS was updated and
maintained, and changes were managed adequately.
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Aligning with the university’s program, the Duke-
NUS Graduate Medical School, a partnership between the
NUS and Duke University, USA, established and nurtured
a safety culture in research laboratories through the imple-
mentation of laboratory SMS. This article explains how the
SMS was used as a tool to foster a safety culture and to get
buy-in from the PIs of research laboratories.
Materials and Methods
The Scheme was rolled out in August 2010 for 34 PIs
involved in wet-bench, laboratory-based research activities
in four research programs: 1) Cancer and Stem Cell Biolo-
gy; 2) Cardiovascular & Metabolic Disorders; 3) Emerging
Infectious Diseases; and 4) Neuroscience and Behavioral
Disorders.
Safety at Duke-NUS is managed by a Safety Commit-
tee and a Safety Team that oversees all aspects of safety
in the school. The Committee reports to the dean of the
school and is responsible for maintaining an open channel
of communications with the senior leadership, whose in-
volvement in the SMS is crucial to its successful imple-
mentation. Comprised of academics and experts in various
fields, the Safety Committee is responsible for setting safe-
ty policies and guidelines, while the Safety Team is respon-
sible for their execution. Researchers have the most updat-
ed knowledge about the hazards involved in their research
activities. The Safety Team tapped this knowledge and
worked together with the PIs and laboratory members to
identify risks and establish appropriate mitigating measures.
This process also enabled the Safety Team to train the PIs
and their laboratory members about the process of risk as-
sessment and implementation of control measures. This
process enhanced their safety awareness and made them
more aware of local regulations, many of which may not
have been obvious given that the researchers are from vari-
ous countries and backgrounds. Thus, the Scheme served as
a platform to increase awareness and increase the rapport
between the Safety Team and researchers, which was a key
factor in cultivating a safety culture. Once laboratories
were enrolled in the Scheme, the PI and her or his team
took charge of their safety management, with guidance
from the Safety Committee and the Safety Team.
The processes involved in rolling out the Certification
Scheme are schematically shown in Figure 1, with detailed
explanation of the key steps described below.
Planning
The implementation of the Scheme was carefully
planned before announcing it to the PIs. The Safety Com-
mittee and the Safety Team realized that rolling out the
Scheme as a pilot project would enable them to test the sys-
tem and refine the process as needed. The pilot batch of
eight PIs enrolled for the certification in Aug 2010; the re-
maining 26 PIs were successfully enrolled in March 2011.
Briefing and Training
PIs and the research team were briefed about the
Scheme and the framework. The briefing sessions served as
a two-way communication channel to gather feedback and
to get buy-in from the PIs. Each PI was required to nomi-
nate a representative who would serve as the “Safety Lead”
for the laboratory. The Safety Leads, who were the key
liaisons for each laboratory, were further trained in the
methodology, and in turn trained the rest of the laboratory
members.

Table 1
Elements of the NUS SMS
1. General Requirements
2. Commitment of the group to the OH&S Management System
3. Hazard Identification, Risk Assessment, and Determining Controls
4. Legal and other requirements
5. Objectives and Programs
6. Resources, Roles, Responsibility, Accountability, and Authority
7. Competence, Training, and Awareness
8. Communication, Participation, and Consultation
9. Documentation and Document Control
10. Operational Control
11. Emergency Preparedness and Response
12. Performance Measurement and Monitoring
13. Incident Investigation, Corrective Action, and Preventive Action
14. Internal Audit

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Figure 1
Development and implementation of a laboratory SMS: Steps taken and outcomes achieved.

Laboratory Register to any person who may be affected by the undertaking in

The first step in the process was for each laboratory
to develop a laboratory register, which consisted of the
compilation of the various documentation required for the
Scheme. Every laboratory was required to develop and
maintain a register in which documents were organized
under various headings based on the NUS framework for
this Scheme (Table 1). Guided by the Safety Team, a core
group of researchers discussed and determined the docu-
mentation for the laboratory register. In particular, the core
group developed templates for risk assessment, which each
laboratory was required to customize based on its own re-
search activities. These templates proved to be of great
value, as they served as a standardized foundation on which
the laboratories built their documentation.
Risk Assessment
Integral to the Safety and Health Management System
is risk assessment. All workplaces must conduct risk as-
sessments to identify the sources of risk and take all rea-
sonably practicable steps to eliminate any foreseeable risk
the workplace. Where it is not reasonably practicable to
eliminate the risk, other reasonably practicable measures
must be taken to minimize the risk according to the Work-
place Safety & Health Regulatory Framework published
by the Singapore Ministry of Manpower (The Workplace
Safety & Health framework: www.mom.gov.sg/workplace-
safety-health/wsh-regulatory-framework/pages/workplace-
safety-health-act.aspx).
Much emphasis was placed on risk assessment and
its methodology as mandated by the Singapore Ministry of
Manpower’s Workplace Safety and Health Regulatory
Framework. A 3x3 matrix was used throughout the school to
assess risk for various research activities (Tables 2a, 2b, and
2c). Researchers were taught to quantify severity and likeli-
hood as explained in Tables 2b and 2c, respectively. Risk
was then calculated as the product of the numbers given to
likelihood and severity and could fall into a range from 1 to
9. The risk, thus derived, was further divided into three lev-
els: low, medium, and high as explained in Table 2a, with
levels 6 to 9 requiring additional risk mitigating measures.

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The Safety Team, together with the researchers, identi-
fied and prepared several risk assessment templates to en-
compass the different activities (e.g., handling of chemi-
cals, handling of infective agents, handling tissue culture,
etc.). Each laboratory was required to customize these tem-
plates for their own activities and identify appropriate con-
trol measures depending on the types of procedures and
research materials involved. This exercise was done in a
group with all the members of the laboratory playing an
active role in the risk assessment exercise. At the end of
this risk assessment training and exercise, all members of
the laboratory were very adept at performing risk assess-
ment for their activities. Great emphasis was placed on the
need to perform hazard identification and risk assessment
as a team, with the person doing the activity taking a key
role. Risk assessments were required to be performed for
all activities regardless of where they were performed, for
example in common areas, instrument rooms, vivaria, etc.
Researchers were trained to perform risk assessments
for their research activities. Examples of factors they con-
sidered include:
• Materials used (e.g., biological, chemical)
• Concentration and quantity of material used
• Toxicity (e.g., microbial toxins)
• Genetic modifications
• Biological, chemical, radiological mixtures/interactions
• Usage of drugs of known/unknown toxicity
• Waste management
• Procedural risks (e.g., potential for aerosol generation)
• Instruments used (e.g., sharps, centrifuges)
• Type of work (e.g., whether repetitive procedures would
be used, resulting in fatigue)
• Behavioral factors (e.g., working too fast, low opinion
of safety programs)
In addition to the above factors, the researchers were
trained to rely upon their experience and realistic scenarios

Table 2a
3x3 Matrix Used for Risk Assessment
Likelihood
Likely (3) Possibly (2) Unlikely (1)
Low (1) 3 2 1
Severity Medium (2) 6 4 2
High (3) 9 6 3
Risk = Severity x Likelihood, varies from 1 to 9
<3 Acceptable Residual Risk Low
3, 4 Additional Risk Control to be considered Medium
>4 Additional Risk Control required High

Table 2b
Assessing the Severity of the Risk
Score Severity Description
No injury, injury or ill health requiring first aid treatment only—includes minor cuts and
1 Low (Minor)
bruises, irritation, ill-health with temporary discomfort
Injury requiring medical treatment or ill-health leading to disability, includes lacerations,
2 Medium (Moderate)
burns, sprains, minor fractures, dermatitis, deafness, work-related upper limb disorders
Fatal serious injury or life threatening, occupational disease, includes amputations, major
3 High (Major)
fractures, multiple injuries, occupational cancer, acute poisoning and fatal diseases

Score Severity
1 Unlikely (Remote)
2 Possible (Occasional)
3 Likely (Frequent)
Table 2c
Determining Likelihood
Description
Not likely to occur (has not occurred in the PI’s laboratory or similar laboratory setup)
Possible or known to occur (has occurred in the PI’s laboratory or similar setup)
Common or repeating occurrence (has occurred repeatedly in the PI’s laboratory or
similar laboratory setup)

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to adequately assess risk. Researchers were trained to walk
through an activity in a “start-to-finish approach” to identi-
fy and address all risks associated with the activity. Some
examples of factors taken into consideration include:
• Past experience/incidents
• Number of years of experience of the researchers
• Availability of adequate supervision
• Complexity of the activity
• Number of personnel involved in the activity
• Frequency of performing the activity
• Degree of control (e.g., involvement of non-laboratory
trained persons)
• Adequacy of administrative controls (standard operat-
ing procedures) and training
Creation of Generic Risk Assessment Templates
and Customization by Each Laboratory
Generic risk assessment templates were created based
on common research activities carried out in various labor-
atories. The following generic templates were developed
in discussion with the core group: 1) Tissue culture work;
2) Radio-isotope work; 3) Handling of chemicals; 4) Bacte-
rial work; 5) Nucleic acid work; 6) Microscopy and immu-
nofluorescence; and 7) Protein work.
The generic templates provided a standardized frame-
work for the laboratories, which the Safety Leads in each
laboratory used to add information specific to their laborato-
ry activities and compile in their register. This was achieved
through discussions with the laboratory member(s) who was
actually performing the specific activity to ensure that the
risk assessment was not merely a paper exercise. An exam-
ple of a risk assessment is shown in Table 3.
Standard Operating Procedures (SOPs)
SOPs were developed at the university, school, or la-
boratory level based on applicability. Specific SOPs for
laboratories were developed only when the university or
school-level SOP was not able to adequately address the
risk. An example of such a laboratory-level SOP would be
the injection of radioactive-labeled material into mice. In
this case, a laboratory-specific SOP was drawn up to man-
age radioactive animal carcass disposal.
Internal and External Audits
An internal audit was conducted by specially trained
peers who, together with members of the Safety Team,
performed the audit. Internal audits mimicked formal exter-
nal audits, including document review, laboratory site vis-
its, and interviews with laboratory members. The findings
of the internal audit were made known to the PI in a written
report with corrective action required before the external
audit. This process of internal audit allowed the PI and his
or her laboratory members to familiarize themselves with
the audit methodology. Furthermore, it allowed the Safety
Team to assess the laboratory for its preparedness and to
further train the laboratory members on the value of imple-
menting an SMS.
External audits were conducted by trained auditors

Table 3
Example of Activity-based Risk Assessment
Description/ Existing
Possible Risk Additional
No. Details of Steps Hazards Risk Severity Likelihood
Accidents Level Control
in Activity Control
1 Get vials from Possible Frostbite Use 2 1 2
Liquid nitrogen Exposure to cryogloves
liquid and face
nitrogen shields
2 Thawing of Breakage/ Eye injury Use 3 1 3
human samples explosion of due to cryogloves,
stored in liquid vial due to explosion face shield
nitrogen the of vials and lab
temperature coats when
difference handling
frozen
vials.
Exposure to Lab Work in a 3 2 6 Hepatitis B
human blood acquired BSL-2 lab, vaccination
borne infection Use class II (occupation
pathogens Biosafety al health
(e.g., HBV, cabinet, program)
HCV, HIV goggles and
etc.) from lab coat
human
cells—(Risk
Group 2)

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either from the university’s Safety Office or external agen-
cies. Of the 34 PIs who underwent the audit, 31 were en-
rolled in the Scheme on the first attempt. The remaining
three, were found to have gaps in the implementation of the
SMS, and were given 3 months to address them.
Conclusions
Currently, 34 PIs in the school are enrolled in the
Scheme. Newly hired PIs are given a year to prepare their
laboratories for the Scheme, during which they work close-
ly with the Safety Team to put a robust SMS in place. Once
certification is achieved, the laboratory register becomes
an integral part of the laboratory. It is used for training
and orienting new members to the laboratory and during
monthly inspections to ensure that risk mitigating measures
are followed. The laboratory register also serves as a one-
stop reference for regulatory requirements in terms of rec-
ords and documentation.
Several benefits have been derived from this Scheme
including:
• Safety awareness has increased significantly among
every member of the research team. This is seen in the in-
creased vocalization of safety concerns during laboratory
meetings.
• The bottom-up approach allowed every member of the
laboratory, from students to post docs, to take an active part
addressing safety issues.
• Researchers are trained and empowered to identify and
address the safety issues in their laboratory activities.
• Reading safety data has become an integral part of
scientific activities and every team devotes 5 to 10 minutes
of every laboratory meeting to discussing safety issues that
arise.
• Researchers are willing to discuss issues and participate
in decision-making since their understanding of safety
issues has improved.
• The school’s Safety Team was able to identify common
issues and ensure that best practices were standardized and
shared throughout the school.
• Several poor/improper practices came to light involving
chemical storage, disposal of cytotoxic drugs, and labeling
of cage cards in the animal facilities, for example, and were
addressed jointly by the researchers and the Safety Team.
• There is a clearer understanding of roles and
responsibilities in the laboratory.
• There is an improved understanding of the legal
requirements; researchers are comfortable in approaching
the Safety Team when they feel that regulatory approvals
are needed.
• There is a clearer understanding of legal requirements
and active participation in feedback to the regulatory bodies.
• The school’s Safety Team is seen as facilitator and
administrative companion rather than as policing.
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Future Plans
The Scheme has now been in force for just over 2
years and the Duke-NUS Safety Team will continue to
monitor its efficacy. In particular, the Safety Team hopes to
wean researchers off a dependence on the Safety Team so
that researchers are able to self-regulate the laboratory’s
safety more effectively. Over the next 3 years, the Safety
Team aims to develop parameters to objectively measure
the success of this Scheme.
Acknowledgments
This project was made possible by the Duke-NUS
Graduate Medical School, Singapore’s operating budget.
*Correspondence should be addressed to Viji Vijayan at
viji.vijayan@duke-nus.edu.sg.
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