Diagnostic Medical Parasitology. Lynne Shore Garcia
no longer appear in the final rule.
F. How can the employer ensure that the employee uses appropriate PPE?
“It is not the intent that the employer ‘watch over everyone’s shoulder’ for compliance, but there are reasonable policies and regulations that employees follow.”
G. What does the standard say about accessibility, cleaning, repair, removal, and storage of PPE?
“The employer shall ensure that appropriate personal protective equipment in appropriate sizes is available and is accessible at the worksite; the employer shall clean, launder, and dispose of personal equipment; the employer shall repair or replace when necessary at no cost to the employee. If a garment is penetrated by potentially infectious materials, it shall be removed ASAP and replaced by clean garments. When these garments are removed, they must be placed in a designated area or container for storage, washing, decontamination or disposal.”
H. What is the employer’s responsibility if PPE or the hepatitis B vaccine is refused?
“The employer shall ensure that the employee uses appropriate personal protective equipment unless the employer shows that the employee temporarily and briefly declined to use personal protective equipment when, under rare and extraordinary circumstances, it was the employee’s professional judgment that its use would have prevented the delivery of health care services or would have created an increased hazard to the safety of the worker or co-worker. When an employee makes this decision, the circumstance shall be investigated and documented in order to determine whether changes need to be made to prevent such reoccurrences.”
If the employee declines to accept hepatitis B vaccination, a form indicating that fact must be signed by the employee and held in the file.
I. What training is required for employees?
“Training must be available at the worksite, at no cost to the employee, and during working hours. It shall be provided at the time of initial assignment to tasks where exposure may occur, within 90 days after the effective date of the Standard, and at least annually thereafter.”
J. What type of training is required for personal protective equipment?
“An explanation of the use and limitations of methods that will prevent exposure is required, including engineering controls (biosafety cabinets), work practices, and personal protective equipment. Information on types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment must be presented, in addition to an explanation of the basis for selection of such controls.”
Hepatitis Exposure Protocol (4)
Laboratory personnel have a high risk of contracting hepatitis for the following reasons:
1. Frequent close personal contact with patients with hepatitis
2. Direct and frequent contact with biological specimens containing the virus
3. Frequent opportunity for accidental puncture wound with contaminated needles and sharp objects
4. Carelessness in handling specimens
5. Inadequate or unsafe disposal of contaminated needles, specimens, or other objects
6. Carelessness in proper and frequent hand washing technique
The prevention of hepatitis is the primary reason for the emphasis on infection control precautionary measures found in any safety manual (e.g., no smoking, eating, drinking, or mouth pipetting, and procedures for safe specimen handling). These same procedures also apply to HIV.
All known hepatitis specimens must be so labeled; however, to minimize exposure to the virus, every specimen should be handled as though it could transmit hepatitis. Studies have shown that hepatitis may be transmitted to laboratory personnel in several ways:
1. Puncture or other wounds (HIV)
2. Abrasions of the skin (HIV)
3. Aerosols (inhaled into the respiratory tract)
4. By mouth (oral route)
5. Direct contact with the patient
6. Splashing material into the eyes
The following protocol should be followed in the event of exposure:
1. Immediately wash the exposed area with soap and water.
2. Report the incident to the supervisor and laboratory personnel office.
3. Consult with a physician in Employee Health Facility concerning possible recommendations (e.g., administration of immune serum globulin).
Dangerous Properties of Industrial Materials
OSHA requires each laboratory to develop a comprehensive, written chemical hygiene plan (CHP). Every hazardous chemical in the laboratory, regardless of the type of risk, volume, or concentration, must be included in the CHP. The plan should include storage requirements, handling procedures, location of OSHA-approved material safety data sheets, and the medical procedures that are to be followed if exposure occurs. The CHP must specify the clinical signs and symptoms of the environmental conditions (such as a spill) that would give the employer reason to believe that exposure had occurred. When such conditions exist, the CHP should indicate the appropriate medical attention required.
Ethyl ether (also known as ether, anesthesia ether, diethyl ether, ethyl oxide, sulfuric ether, and ethoxyethane) is so volatile that dangerous concentrations are readily built up in the laboratory atmosphere. It is highly flammable and has a tendency to form explosive peroxides. Its low flash point, low ignition temperature, wide explosive range, high volatility, and very heavy vapor (which tends to “pocket”) combine to make ethyl ether an extremely serious fire hazard. The spontaneous formation of explosive peroxides presents severe risks to the user who does not apply precautionary practices. Therefore, it is mandatory to follow these safety procedures (31, 32).
1. Date cans of ether immediately upon receipt.
2. Do not attempt to open a can that is 1 year old (after time of receipt); peroxides may form in sealed cans and explode when the cans are opened. Order appropriate quantities to avoid expensive waste.
3. Date the can of ether when opened; do not use after 1 month. Order cans of appropriate size to avoid waste.
4. Store opened (corked) cans of ether close to the floor, in a cool place, on a shelf, or in a cabinet that is not airtight. The heavy vapors can dissipate along the floor, with less opportunity for contact with sources of ignitions such as an open flame and electric sparks.
5. Never store opened cans of ether in a refrigerator, since ether still vaporizes at refrigerator temperatures. If peroxides have formed from ether, merely opening the refrigerator door may trigger an explosion. The heavy vapors that collect in an airtight refrigerator may ignite on contact with the electrical refrigerator motor. This recommendation also applies to “shielded” refrigerators (those in which the electrical systems are protected).
6. Unopened cans may be stored with opened cans (near the floor on an open shelf or nonairtight cabinet), in a storage cabinet for flammable materials, or in a storage room for volatile substances.
7. Outdate and discard cans after storage for 1 month (if opened) or 1 year (if unopened).
8. Flush empty, or almost empty, ether cans with copious amounts of water before discarding. “Empty” cans have been known to explode! Do not flush more than the contents of a 0.25-lb (ca. 0.1-kg) can down the drain; consult the Research and Occupational Safety Office or the local fire department for proper disposal of large quantities. Empty, thoroughly rinsed cans may be discarded in the regular trash.
9.