Universal Precautions and Laboratory

Safety
I. Introduction
Universal precautions are infection control guidelines designed to protect workers from
exposure to diseases spread by blood and certain body fluids. Universal precautions stress that
all patients should be assumed to be infected with blood-borne diseases such as AIDS and
hepatitis B, since all patients harbouring blood-borne pathogens cannot be readily identified.

The clinical laboratory contains a variety of safety hazards, many of which are capable of
producing serious injury or life-threatening disease. To work safely in this environment,
laboratory personnel must learn what hazards exist and the basic safety precautions associated
with them, and must apply the basic rules of common sense required for everyday safety. Some
hazards are unique to the healthcare environment and others are encountered routinely
throughout life.

II. General Safety Requirements for Personal and Laboratory Safety

1. Smoking is not allowed in the laboratory.
2. Eating and drinking are also prohibited in all technical work areas. It is poor laboratory
practice and a source of contamination, especially when specimens (e.g. blood, urine, feces,
sputum) containing a variety of pathogens which are handled daily in the technical areas are
stored in the laboratory refrigerators.
3. Food is not permitted to be stored in technical refrigerators.
4. Contact lenses are acceptable eye wear. However, users of contact lenses must wear eye
protectors when necessary. Also, they must have eyeglasses as back-up in the event of
contamination.
5. Face shields or eye protectors must be worn when handling caustic materials.
6. Clothing: Students are required to wear laboratory coats while working in the laboratory.
7. Shoes should be comfortable, with rubber soles and cover the entire foot (lace or loafer
style). In most hospital laboratories, white shoes are preferred. Shoes with open toes or
negative heels are not allowed.
8. Hair should be secured back and off the shoulders in such a manner as to prevent it from
coming into contact with contaminated materials or surfaces and also to prevent shedding
of organisms into the work area especially in bacteriology. It is also important to keep hair
out of moving machinery, such as a centrifuge.
9. Washing hands: Hands should be washed frequently during the day, before leaving the
laboratory, before and after contact with patients and before eating or smoking.
10. Pipetting by mouth is prohibited. Mouth pipetting of specimens and reagents is dangerous.
There are pipetting aids available for every task.
11. Exits and aisles:
a. They must be free of any obstructions. No equipment, chairs, supplies or trash
should block exit routes or areas.
b. Doors to the laboratory should be kept closed, but exit doors must not be blocked,
bolted or obstructed in any way to block egress.
12. Good housekeeping:
a. Dispose of rags in biological solid waste containers.
b. Do not allow trash to accumulate in any area. Trash should be disposed of daily.
13. Glassware:
a. Do not use broken or chipped glassware. Discard it in specially marked "Broken
Glass" containers.
b. Do not leave pipettes sticking out of bottles, flasks, or beakers.
c. Do not attempt to forcibly remove glass tubing inside stoppers. If they get stuck, cut
them off.
d. Decontaminate glass exposed to specimens that may be contaminated with a
variety of pathogens.
e. Dispose of broken or discarded pieces of glass in specially marked separate
containers. Do not pick up broken glassware with bare hands — use some
mechanical aid such as forceps or tongs. (Disposal of broken glass along with paper
and trash is hazardous to the custodial staff.)
f. Hot glass - heated containers should he handled with an insulated glove
14. Centrifuge
a. Do not operate centrifuges unless the covers are closed (including serofuges). Keep
hair, hair ribbons or other dangling items out of the way.
b. Do not centrifuge uncovered tubes or specimens (blood, urine, sputum) or
flammable liquids. (Contaminated items can produce aerosols that may be
flammable or may cause explosion.) Use caps or parafilm.
15. Autoclaves:
a. Students must not operate autoclaves until they have been checked for proper
operation.
b. Do not open them until both temperature and pressure are back to normal.
c. Be sure intake steam valve is off before opening.
d. Use insulated gloves when putting items into or removing items from the autoclave.
The side and door will still be hot in addition to the material being autoclaved.
NOTE: Steam may permeate insulated gloves.
e. Loosen caps of any containers to allow equalization of pressure inside containers.
This prevents explosions, boil-overs and implosions.
f. Cellulose nitrate tubes may explode.
16. Sharps: Caution must be used when handling needles, scalpels and other sharp objects.
Needles should not be bent, broken or recapped. Needles must be placed in a sharps
 container or needle destroyer immediately after use; never stick fingers into a sharps
container.

III. Categories of Hazards in the Laboratory

A. Biological Hazards:
All body fluids and tissues for analysis are considered biological hazard. Substances posing potential
biohazard are whole blood samples, serum and plasma, urine, feces, and other body fluids such as
spinal or synovial fluid, and reagents prepared from human blood products.
UNIVERSAL BLOOD and BODY FLUIDS PRECAUTIONS
Specific guidelines:
 Hand Washing:
o Frequent hand washing is an important safely precaution which should be practiced
after direct contact with patients and laboratory specimens.
o Immediately after accidental skin contact with blood, body fluids or tissues, hands
or other skin areas should be thoroughly washed with soap and water. If contact
occurs through breaks in gloves, the gloves should be immediately removed and
hands should be thoroughly washed.
o Hands should be washed;
 Before eating, drinking, smoking, applying makeup, changing contact lenses
and before and after using the laboratory facilities.
 After the completion of work and before leaving the laboratory.
 Before all other activities which entail hand contact with mucous
membranes, eyes, and breaks in the skin.
 Gloves:
o Students must wear gloves while procuring specimens.
o Hand washing is not necessary if the gloves remain intact during procedure and
through removal. However, if they become grossly contaminated, hands should be
washed after removal.
o After removing gloves, they must be disposed of in biological solid waste container
and must never be reused.
 Laboratory coats and gowns:
o Students must wear a white laboratory coat which is button-closed. This must be
worn at all times at the work station or at times when the possibility of blood or
body fluids maybe splashed on the student.
o Laboratory gowns must be changed immediately if grossly contaminated with blood
or body fluids.
o Laboratory gowns are not to be worn outside the laboratory. The only time a
laboratory coat is allowed outside the laboratory is for phlebotomy or other
technical procedures.
 Masks and Goggles or Face Shields:
o Masks and goggles/face shields are to be worn while opening tubes of blood or
body fluids, particularly if there is a risk of splatter or aerosolization.
 o To reduce the risk of aerosolization, place a gauze pad over the top of the tube
while removing the stopper. Eyeglasses do not provide the adequate splash
protection.
 Specimen Handling
o All blood or body fluid specimens must be kept closed during centrifugation.
o Pouring of a specimen from a tube into a beaker or other container is a process that
can create an aerosol. To eliminate this potential danger, specimen transfer should
be done with a transfer pipette.
o Mouth pipetting is forbidden. Mechanical pipetting devices should be used when
manipulating liquids.
 Waste and Environmental Sanitation:
o Liquid Waste:
 Liquid wastes should be collected in a biological liquid waste bottle which
contains enough clorox so that when the container is full, the concentration
of clorox is 20%, i.e., 1% sodium hypochlorite. When this waste is poured
carefully down the drain, goggles must be worn since there is a risk of
splashing.
 Laboratory instructors should inform a laboratory technician if the biological
fluid waste bottle is full for immediate replacement.
o Solid Waste:
 Laboratory waste that comes in contact with blood or body fluids must be
collected in biohazard plastic bags and tied tightly. This waste must be
collected and taken for incineration.
o Sharps:
 Caution must be used when handling needles, scalpels and other sharp
objects.
 All needles should be destroyed using needle destroyer. Destroyed needles
should be placed in a plastic bag followed by steam sterilization prior to
disposal by the waste disposal contractor.
 Never stick fingers into sharps container.
o Disinfection/Decontamination:
 Spill. Absorb the spilled material with gauze pads and discard in biohazard
trash bags.
 Disinfect the spill site with bleach, freshly made daily, diluted 1:10. Wear
gloves during the entire process.
 Decontamination of counters should be done at the start of the class and
for every spill.
 The surface of analyzers should be decontaminated daily following the
manufacturers' recommendations.
B. Chemical Hazards
 Exposure to chemicals may be hazardous to laboratory workers Hazards include toxicity,
flammability, explosiveness, skin irritations, bums or a combination of these effects.
 When reagent preparation is necessary, all containers should be labelled with the contents
and concentration of the reagents. The expiration date, date of preparation and name of the
person who prepared the reagent should be included.
 Accidents can be prevented by using fume hoods, carriers for caustic chemicals, gloves,
goggles, aprons, and other protective coverings when handling chemicals
 Storage of volatile chemicals specially ventilated cabinets is necessary
 Mouth pipetting is strictly prohibited to reduce the possibility of injury through exposure to
caustic chemicals.
 When skin contact occurs in chemical spills, the best first aid is to flush the area with large
amount of water. Contaminated clothing should be removed the soonest possible. No
attempt should be made to neutralize chemicals that come in contact with the skin.
 In chemical handling, chemicals should never be mixed together, unless specific instructions
are followed; they must be added in the order specified. This is important when combining
acid and water. Acid should always be added to water and not vice versa, to avoid possibility
of splashing.
 Wearing goggles and preparing reagents under a fume hood is a recommended safety
precaution.
 In chemical labelling, hazardous chemicals should be labelled with a description of their
particular hazards, such as poisonous, corrosive, or carcinogenic.
C. Radioactive Hazards
 Radioactivity is encountered when procedures using radioisotopes are performed in the
clinical laboratory. Persons working in a radioactive environment are required to wear
devices to determine the amount of radiation they accumulate.
D. Sharp Hazards
 Sharp objects in the laboratory, including needles, lancets and broken glassware, provide a
serious biological hazard, particularly the transmission of blood-borne Infections. At sharp
objects must be disposed of In puncture-resistant containers that am conveniently located
within the work place
E. Electrical Hazards
 The danger of water or fluid coming in contact with equipment is greater in the laboratory
setting. Equipment should not be operated with wet hands.
 When equipment is wet, it should be unplugged and allowed to dry completely before
reusing it.
 Before cleaning the machine, make sure to unplug it.
F. Fire/Explosive Hazards
 Laboratory workers often use potentially volatile or explosive chemicals that require special
procedures for their handling and storage. Flammable chemicals should be stored in safety
cabinets.
  Cylinders of compressed gas should be placed away from heat and securely fastened to a
stationary device to prevent accidental capsizing.
 Fire blankets must be present in the laboratory. Persons with burning clothes should be
wrapped in blankets to smother the flames.
 Fire extinguishers must be located in strategic places in the laboratory. Technologists must
be able to distinguish among the types of fire extinguishers available and should be experts
in using them.
 Fire plans should be posted and fire drills should be conducted periodically.

Fire Extinguishers

Classes of Fire Type of Extinguisher

A. Combustibles Pressurized Water
Paper, Wood, Cloth Dry Chemical
B. Flammable Liquids Dry Chemical
Grease, Gasoline, Oil Carbon Dioxide
C. Electrical Carbon Dioxide
Dry Chemical

A MESSAGE TO MEDICAL TECHNOLOGY STUDENTS AND FUTURE

REGISTERED MEDICAL TECHNOLOGISTS

You – are a highly trained and valuable resource. We do not want you to be “wasted”
by a needless accident.

You – are the only one who can practice safety procedures for your protection and
that of your fellow members.

You – have the responsibility to:

o Be aware of safety hazards

o Follow policies and procedures designed to protect you

o Report all incidents and accidents so that steps may be taken to

prevent their reoccurrence and to keep you safe always.

SO

BE CAREFUL BECAUSE THE LABORATORY IS A HAZARDOUS AREA!