Student Safety Manual

Health Science Programs Prince Philip Drive Campus

Revised August 2017

Table of Contents Revision Record Introduction 1 Emergency Contact Numbers 1 Occupational Health & Safety 2 Building Safety Rules 3 Personal Safety 3 Latex Sensitivity 4 Scent Awareness 5 Health and Pregnancy for Health Science Students 5 Electrical Safety 6 Proper Lifting Techniques 7 Ergonomics 7 Fire and Safety Prevention 9 Emergency Measures 13 Evacuation Plan 13 Active Intruder Plan 13 First Aid/ Medical Emergencies 16 Accident/ Incident Reporting 20 General Laboratory Safety 21 Access to Lab 21 Good Lab Practice 22 Personal Protective Equipment 24 Safety Equipment 26 Emergency Wash Stations 26 Chemical Fume hoods 26 Equipment Safety 27 Waste Disposal 29 Chemical Safety 32 WHMIS 1988/2015 32 Chemical Handling 42 Chemical Spill Response 46 Biological Safety 47 Routine Practices/Standard Precautions 48 Risk Assessment 49 Hand Hygiene 49

Personal Protective Equipment 50 Environmental Controls 52 Administrative Controls 52

Use and Disposal of Sharps 53 Sterilization and Disinfection 53 Handling Patient Specimens and Cultures 54 Safety Equipment 55 Biological Safety Cabinet 55 Equipment Safety 58 Biological Spill Response 60

Laboratory Acquired Infections 61

Table of Contents

Compressed Gas Handling 62 Radiation Safety 66 Glossary 69 Appendix 1 Incident Report Form 69 Appendix 2 Needlestick/Biological Exposure Incident Report Form 71

Revision Record

Version Date. Page Paragraph Description of Changes

Aug 2017 Table of Contents Page #’s Changed

5 Pregnancy and students using X-ray equipment

Moved to X-ray Safety Program

7 ERGONOMICS - SITTING Added: •Take regular breaks. Get up and move around periodically.

16 FIRST AID/ MEDICAL EMERGENCY

Added AED located in the gym

18 FAINTING Edited to read •Place the casualty in the recovery position, if injuries permits

22 GOOD LAB PRACTICE Ingestion of hazardous materials

Edited to read •Contact lenses are not permitted in laboratories where chemical and biological materials are present.

25 PERSONAL PROTECTIVE EQUIPMENT Eye and face protection

Added: •Disposable face shields DO NOT provide suitable eye protection for chemical use.

27 EQUIPMENT SAFETY Added HEAT PRODUCING DEVICES (BUNSEN BURNERS/ HOTPLATES/ MICRO-INCINERATORS) •Open flame should not be lit if any flammable liquids (e.g. alcohol, acetone) are nearby. •Maintain a clear work area around all heat producing devices. •Do not use an open flame to heat flammable liquids. •Do not leave the burner or heater unattended. •Turn off and unplug the burner or heater when not in use. •Use care in handling hot waxes, base plates and other heated material.

29 CHEMICAL WASTE Edited to read: •Do not overfill container (70-80% full only). Before adding waste to collection containers check the level in the container. DO NOT overfill.

31 Human blood and body fluid waste - Urine

Changed to autoclavable tray

32 WHMIS -EDUCATION & TRAINING

Removed reference to Clinical placement requirements

53 DISINFECTANTS Removed “Factors Effecting Disinfectant Use” section

58 PIPETTING DEVICES Added: •If the pipettor is contaminated internally, notify your instructor so the entire unit can be disassembled and decontaminated by lab personnel.

CENTRIFUGE Added: •When in use the inside of bowl must be cleaned daily by the operator and maintenance should be documented.

61 LAB-ACQUIRED INFECTIONS (LAI) Added: •You must complete the Laboratory Acquired Infections Course on the PHAC website.

66 RADIATION SAFETY Operational information moved to X-ray Safety Program

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INTRODUCTION The guidelines presented in this manual are applicable to the majority of clinical and scientific laboratories, but are not intended to be an authority on the subject of laboratory safety. This information will be supplemented by detailed additional materials where applicable. Safety is of supreme importance. The safety practices outlined in this manual are designed to educate the student in methods that are used to minimize hazards in the work environment. Every effort must be made to plan work so that all foreseeable hazards are eliminated and all possible aids provided. It is important to recognize that hazards exist in ANY laboratory, and ALL specimens should be considered a potential hazard. All students using the laboratories in F-block at PPD receive a copy of this manual. It is the responsibility of the student to READ all applicable sections and to PRACTICE the safety regulations. Students in Medical Laboratory Technology are required to purchase and follow the CSMLS Guidelines for Laboratory Safety. Students in Medical Radiography are provided with a copy of the Safety Code — 35: Radiation Protection in Radiology- Large Facilities; Safety Procedures for the installation, Use and Control of X-Ray Equipment in Large Medical Radiological Facilities Students must follow the safety protocols established by the College and hospital sites during clinical training.

EMERGENCY CONTACT NUMBERS

Security and Emergencies Cell: 682-9552 Pager: 778-1710 Office: 758-7283 Campus Nurse: 758-7289 Fire Department, Ambulance, Police 911 Storm Line & Closings 758-7278 NOTE: If calling from a CNA phone you must dial “9” to obtain an outside line.

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OCCUPATIONAL HEALTH AND SAFETY The College of the North Atlantic believes that Health and Safety is a team effort which involves the employer, the employee and student. Under the Occupational Health and Safety Act for the Province of Newfoundland and Labrador, there are both general and specific areas that relate to the laboratory and clinical settings. From this act an employer shall ensure:

Where it is reasonably practicable, the health, safety and welfare of his or her workers.

Where it is reasonably practicable, provide and maintain a workplace and the necessary equipment, systems and tools that are safe and without risk to the health of his or her workers

Provide the information, instruction, training, supervision and facilities that are necessary to ensure the health, safety and welfare of his or her workers.

The College of the North Atlantic adheres to the requirements to protect individuals that use the facilities as required under the Occupational Health and Safety Act. A worker shall take reasonable care and co-operate with his or her employer, with other workers in the workplace to protect his or her own health and safety, the health and safety of other workers engaged in the work of the employer and the health and safety of other workers or persons present at or near the workplace. Health and Safety is important and a worker may refuse to do work that the worker has reasonable grounds to believe is dangerous to his or her health or safety, or the health and safety of another person at the workplace. When a worker exercises his or her right to refuse to work, the worker shall immediately report it to his or her supervisor. The Occupational Health and Safety Act applies specifically to employers and employees, however, students are expected to comply with safety requirements as specified by the Act and Regulations. Students should:

Be familiar with the safety policies and use the procedures to ensure a safe workplace.

Attend the laboratory safety session and participate in provided training programs.

Use personal protective equipment, clothing and other equipment required.

Work in a manner that will not endanger themselves or others.

Report any medical incidents and/or occupational injuries to your instructor and/or the Campus Nurse.

If an incident occurs during clinical training, students MUST follow the protocol established by the hospital AND the College. Required documentation must be submitted within 24 hours.

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BUILDING SAFETY RULES Eat lunches and snacks in designated areas only. Food and drinks are NOT

permitted in laboratories.

Smoking is NOT permitted in any area of the Campus.

Horseplay in the workplace/laboratory is strictly forbidden.

Aisles, halls, offices, classrooms and stairways must be kept free of all obstructions and defects which might cause slips or falls.

When opening a door that leads to a corridor, proceed cautiously to avoid a potential collision.

Use small ladders or step stools to reach items stored overhead. Do not climb onto chairs, shelves or filing cabinet drawers.

Dispose of all garbage properly.

PERSONAL SAFETY WHAT TO DO IN AN EMERGENCY

An Emergency May Include:

Fire, smoke or smell of gas

Life safety

Bomb threats

Accidents/serious sickness

Crimes in progress

Suspicious persons or incidents

At PPD Campus call Security: Office—758-7283, Cell—682-9552, Pager—778-1710 or call 911 if necessary

Do not endanger yourself or attempt to deal with hazardous or suspicious situations yourself.

GENERAL ADVICE

Know the emergency number to reach Security.

Be aware of what is going on around you.

Follow your instincts. If you feel you are at risk, try to leave the situation or area quickly.

If you are harassed, report the incident to Security.

Use the buddy system. Plan to watch out for one another.

Do not leave purses, wallets, cash and valuables unattended.

AFTER HOURS AND AT NIGHT

If you suspect you are being followed, indicate your suspicion by looking behind you.

Change directions and vary your speed of walking. Immediately, head for a place

where there are other people.

Be aware of people around you and your work area.

Try to stay in well-lit areas and use routes that are frequently traveled by others.

Know which entrances to the college building are locked after hours, and try to park your car as close as possible to afterhours access doors.

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PARKING LOTS

When you know you will be returning to your car at night, park in a well-lit area.

Have your keys ready in your hand before you reach your car.

Visually check the interior of your car before getting in.

ELEVATORS If the elevator should breakdown with you inside, push the alarm button until someone responds. Do not attempt to pry open the doors or escape through the roof hatch. You are safer inside the car until qualified help arrives. Once help arrives, follow their instructions. BANK MACHINES Be aware of other people around you before and during usage of bank machine.

LATEX SENSTIVITY

Latex allergies have increased, and occur with relatively high frequency in certain populations, especially with health care workers, certain patients, and workers who may be required to use latex products in their day to day work environment. Efforts have been taken to minimize latex exposure in the School of Health Sciences laboratory area; such as:

Using non-latex (nitrile or vinyl) non-sterile gloves.

Using powder-free sterile latex gloves.

Using glove liners if latex must be used.

Other medical supplies (oxygen masks, tourniquets, etc.) will be latex free (where possible).

Although the symptoms vary from case to case, the most common reaction is irritant contact dermatitis - the development of dry, itchy, and irritated areas on the skin, usually the hands. Other reactions may include rashes and skin blisters which can spread away from the area of skin touched by the latex. More severe reactions may involve respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma. Rarely anaphylactic shock may occur. A life threatening reaction is seldom the first sign of latex allergy. Anyone with sensitivity to latex must:

Notify their instructor and the Campus Nurse.

Use only non-latex gloves, and avoid all latex-containing products.

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SCENT AWARENESS Scented products contain chemicals that can cause problems for many people, especially those with asthma, allergies and chemical sensitivities.

All staff and students must refrain from wearing scented products in the workplace.

Any persons wearing obvious scent may be asked to wash it off and/or change clothing before entering the laboratory or classroom areas.

The following is a short list of products that may cause problems for those with scent or chemical sensitivities:

Perfume/Cologne Aftershave

Scented lotions Soap

Air fresheners/Deodorizers Scented Deodorants

Hair Products (e.g. shampoo, conditioner, hairspray, etc.)

Cleaning Products (bleach, laundry detergent, etc.)

Fabric softeners Flowers, such as lilies, roses

HEALTH AND PREGNANCY FOR HEALTH SCIENCE STUDENTS Students and employees in the School of Health Sciences can be exposed to health risks not experienced by students and employees in other areas of the College. These risks may be greater if the student or employee has physical conditions such as, but not limited to: immuno-suppression and pregnancy.

Be aware of the potential health risks associated with working in a clinical laboratory environment on campus and during clinical placement.

Take the required and recommended steps to ensure that the risks are minimized as instructed in each laboratory.

Seek the advice and guidance of a physician in the event that the student or employee has physical conditions that make them more vulnerable to the routine risks.

Students and employees who become pregnant, immuno-suppressed or have health conditions that predispose them to risk during any part of their involvement in Health Science Programs, are strongly encouraged to notify their instructor/ supervisor/ instructional coordinator and/ or the Campus Nurse to discuss health risks, plans for continuation in the program, confidentiality issues, etc. In some cases it may be in your best long-term interest to postpone some courses. Modification of tasks to reduce exposure may be necessary.

Students and employees who return to work while continuing to breastfeed should notify

their instructor/supervisor/coordinator and/or Campus Nurse to discuss any potential

hazards.

Students must accept responsibility for using appropriate safety measures to protect their own health (and that of the fetus, if pregnant).

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ELECTRICAL SAFETY

It is essential to have adequate knowledge of electrical safety as it applies to the various types of equipment used during laboratory sessions. Precautions required when working with electrical equipment:

Ensure that hands and work surfaces are dry before touching electrical equipment or connecting cords.

Most equipment has been equipped with a three-pronged grounded plug (the ground pin should never be removed).

Do NOT use electrical equipment with fraying cords. Report any damage to your instructor.

In the event of a shock (even if minor) or emission of smoke or a burning smell, immediately tag the equipment “Out of Service” and remove it from use. Report to your instructor.

Remove cords from receptacles by grasping and pulling the plug, not the cord.

Keep all electrical cords way from heated surfaces, such as hotplates.

Ensure that all cords are kept off walkway floors where they can become a tripping hazard or be damaged.

When setting up an instrument or appliance in a workplace, ensure adequate air circulation around the unit to prevent overheating.

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PROPER LIFTING TECHNIQUES

The number one cause of back injury is lifting. Proper body mechanics and lifting principles should be employed whenever possible to reduce the likelihood of injury.

Size up or test load to see if you can handle it.

Avoid heavy loads - split larger loads into smaller ones, get help.

Determine where you are lifting the object to, and where you will place it.

Make sure the route or path that you will take is clear.

Tighten your abdominal muscles to help brace your back as you lift.

Keep your back straight. Bend at your knees as far as you can and still be able to return to an upright position.

Initiate the lift with your leg and buttock muscles.

Keep the object close to your body.

Keep your head higher than your shoulders.

Grip with both hands - not just your fingers.

Lift with controlled speed.

Come to an upright position using your leg and buttock muscles.

Keep object close to your body.

Do not over extend when reaching. Get a ladder or tool to handle high objects.

Push instead of pull.

Never twist at the waist when lifting or carrying. Pivot using you feet.

Try to store objects between shoulder and knuckle height.

When lifting to shoulder height: Lift the object to your waist. Brace object to allow you to bend your knees and place both hands under item.

Straighten your legs to raise the item and slide it onto the shelf.

Place objects on shelf by extending arm while keeping your back straight.

More information and additional resources can be found at www.whscc.nl.ca/prevention/backagents.whscc

ERGONOMICS Some examples of measures you can use to work safely and avoid musculoskeletal injuries in the laboratory are:

SITTING

Ensure chair is correctly adjusted and supports lower back.

Rest feet flat on floor or footrest.

Knees should be bent at approximately 900 angle.

Ensure that chairs with casters are in position and will not move as you sit in place.

Take regular breaks. Get up and move around periodically.

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WORKSTATION

When using keyboard or mouse, keep arms in comfortable position with elbows by side.

Position top of the monitor at eye level.

When using telephone do not cradle receiver between ear and shoulder.

Work space should be arranged to avoid excessive bending, reaching, twisting and stretching.

Lighting must be task appropriate.

PIPETTING

Mechanical pipets should be designed for easy handling.

Keep work at elbow height and as close as possible.

Do not twist or rotate at the wrist.

Hold the pipettor with a relaxed grip and alternate hands if possible.

Rotate pipetting jobs with other jobs or take short breaks every 20-30 minutes.

MICROSCOPE USE

Use a well adjusted chair and sit close to the microscope. Sit properly in the chair, not perched on the edge.

Make sure the microscope eyepieces are in line with or over the front edge of the bench.

The vertical position of the eyepieces should be a little high for comfort, as this forces you to keep your head upright and reduce strain on your neck.

Look slightly downward into the eyepieces, instead of tilting your head down and looking straight ahead. Keep your back vertical and your head and neck upright.

Your forearms should be rested on the bench.

Make sure the inter-pupillary distance is adjusted.

Take regular breaks. Get up and move around and focus your eyes to distant vision periodically.

EMBEDDING TISSUE

Maintain good sitting posture.

Do not lean your arms on sharp or hard surfaces.

Keep as many items as possible within your reach.

Keep joints in a neutral position.

Alternate the motion used to open cassettes lids.

Take periodic breaks to walk around and exercise wrists and fingers.

Use ergonomic forceps.

MICROTOMY

Maintain good sitting posture.

Use a well adjusted chair and a foot rest if necessary.

Keep joints in a relaxed, neutral position.

Do not rock the hand wheel (wrist flexion and extension).

Take periodic breaks to walk around and exercise wrists and fingers.

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FIRE SAFETY and PREVENTION

The Fire Safety Plan for Prince Philip Drive Campus is based on the requirements of the National Fire Code of Canada. It provides emergency procedures and actions to be taken in the event of a fire and fire protection measures. The information in the Fire Safety Plan will help the occupants in utilizing life safety features in the building and ensure an orderly evacuation at the time of an emergency.

WHAT TO DO IF YOU DISCOVER A FIRE Any person discovering a minor fire should fight the fire by using a portable fire extinguisher ONLY if the fire is small and NOT between you and the exit. If the fire is extinguished, notify an instructor immediately.

DO NOT RISK YOUR LIFE TO FIGHT A FIRE

Any person discovering a major fire or smoke should, without delay:

Activate the manual fire alarm pull box station.

Immediately evacuate the building.

Notify Security of the area of the building involved: Office 758-7283

Cell phone 682-9552 Pager 778-1710

Leave a message stating: “This is a fire emergency.”

FIRE PREVENTION RULES Smoking is NOT permitted on College of the North Atlantic property.

Report electrical malfunctions, broken electrical fixtures or equipment immediately to your instructor/ supervisor.

Only authorized personnel are permitted entry to any furnace room, electrical room or mechanical room.

Accumulation of combustible waste materials in any area is to be avoided.

No materials of any kind are permitted to be placed so as to obstruct an exit, stairway, fire escape, or landing.

Greasy or oily rags or paper shall not be mixed with regular combustible refuse, but shall be placed in an appropriate covered metal container.

Vehicles parked outside, preventing ready access for firefighting equipment, will be towed away immediately at the owners' expense. A fine may also be levied.

Storage of combustible material must be in approved safety cabinets.

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FIRE SAFETY INFORMATION

Fire Response Plan/ Fire Orders

Posted through the building Shows evacuation routes

Fire Alarm Box/Pull Stations

Throughout the building You must be familiar with the area you are working in

Fire Exits Marked with EXIT sign Know location of fire exits, i.e., all stairwells to the outdoors

Fire Doors Fire doors limit the spread of fire from floor to floor and must not be wedged open

Fire Detection Automatic smoke or heat detection systems are provided. Sprinkler systems engage automatically

Fire Drills All persons using the building must participate in fire drills The drill may take place at any time

The following information is presented for information purposes. In the event of a fire, students and employees must evacuate the building as per the fire regulations.

THE FIRE TRIANGLE In order to have a fire there are three requirements, 1) oxygen 2) burnable material (fuel) 3) an ignition source.

All buildings contain fuel sources and air that promote combustion. Heat is generally the only requirement to cause fires. Some sources of heat are:

-overloaded electrical circuits

-faulty wiring, switches and electrical appliances

-volatile fumes and gases

CLASSIFICATION OF FIRE

Classification of Fire Source Example

Class A Combustibles Wood, paper, cloth

Class B Flammable liquids Solvents, greases, paints

Class C Electrical Instruments, computer

Class D Combustible metals Sodium, potassium

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FIRE EXTINGUISHERS

Description Water

contain water under pressure

usually quite large and heavy

Carbon Dioxide

contain carbon dioxide

recommended for potential chemical fires since CO2 is an inert gas

does not damage computer/electronic equipment

Dry Chemical

multi-purpose

a respiratory irritant

slightly corrosive

will damage sensitive computer/electronic equipment

Use Class A only Using a water extinguisher on Class B or C fire will only serve to spread the fire and intensify the damage caused by the fire

Class B, C Ineffective on Class A fires. Must be applied as close to the base of the fire as possible

Class A, B and C

Discharge Range

30 - 40 feet 3 - 8 feet 5 - 20 feet

Discharge Time

60 sec 30 sec 30 sec

Use of Extinguishers Portable fire extinguishers should only be used when there is a reasonable chance of putting out the primary fire with one extinguisher, or to buy time to evacuate the area. Successful use of portable fire extinguishers depends on several factors, which must be considered before you decide to use a portable fire extinguisher on a fire:

What is burning?

Do you have the right type of extinguisher to fight the fire?

Is the fire small enough for a portable fire extinguisher to be effective?

Do you know how to use a portable extinguisher?

Is there an escape route, should your attempts to fight the fire be unsuccessful? As with any tool, in order for it to be effective you must know when and how to use it. Familiarize yourself with both the types and locations of portable fire extinguishers in your work area and the instructions on the extinguisher. Learning to use an extinguisher is as simple as learning to P A S S: Pull the pin on the extinguisher. A twisting and pulling motion works best. Aim the nozzle, horn or hose at the base of the fire. Squeeze or compress the handle to release the extinguishing agent. Sweep the hose from side to side at the base of the fire until it is extinguished.

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FIRE EMERGENCIES Knowing what actions to take in the event of a fire emergency can prevent injury, save lives and help reduce the losses from the fire.

Small fires- If the fire is contained in a small container suffocate the fire by covering with a lid. Do not pick up the vessel. Do not cover with dry towels or cloths. Remove nearby flammable materials to avoid spread of the fire.

Larger fires - If the fire is burning over an area too large for the fire to be suffocated quickly or you discover a larger fire, initiate the evacuation plan.

Clothing on Fire - If clothing is on fire STOP, DROP AND ROLL

Stop – Do Not RUN Drop – To the floor Roll – Over to smother the flames

As soon as the flame is extinguished, go to the nearest shower to cool burn areas. Seek assistance and medical aid.

DO NOT RISK YOUR LIFE TO FIGHT A FIRE.

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EMERGENCY MEASURES

EVACUATION PLAN In the event of a fire, or other major incidents such as gas leaks, chemical spill, etc., everyone must be familiar with evacuation procedures. The signal for evacuation is the sounding of the building fire alarm. Once an alarm has been given, all persons (staff, students and visitors) must evacuate the building.

WHAT TO DO IF YOU HEAR THE FIRE ALARM Leave the building immediately via the designated stairs and corridors.

Do not attempt to secure equipment or remove items from the building.

Do not use the elevators.

Do not run; walk quickly in an orderly manner to prevent panic situations.

Provide assistance to others if required.

If the exit or stairway is blocked due to smoke or other conditions, proceed to alternate (pre-planned) exit route.

Once outside, move away from the exits and to the opposite side of the roadway/ parking lot unless directed otherwise by the Fire Wardens.

Remain outside the building, until an appropriate emergency response authority gives clearance. No one is permitted to re-enter the building until the "ALL CLEAR" is given by the Fire Warden.

Do not attempt to remove any vehicle from the parking area unless directed to do so by the Fire Department.

ACTIVE INTRUDER PLAN INTRODUCTION The possibility of a major violent incident through an active intruder threat on campus is a reality. The level of preparedness for facing such an incident by a campus community may determine the outcome of the incident.

An active intruder threat occurs when an individual or individuals intend to cause harm to others. Most of these threats/incidents end in a short period of time; therefore, it is important to take responsibility for your personal safety and security, trust your instincts, and use care when making decisions. Further, any action taken or not taken during an active intruder threat may involve life threatening risk.

In the event of an active intruder threat, the campus administration will attempt to notify all occupants of the campus through various means of communication (campus closure notification, text messages, emails, Facebook, phones, etc.). Campus administration will work to provide as much available detail as possible regarding the threat and your own safety. Remember, secure your present area quickly, and move people out of open areas into offices and classrooms.

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PREVENTION While the College has campus security, everyone in the college community has a responsibility to take notice of his/her surroundings, and report anything he/she believes to be a potential safety/security concern. Please use the following guidelines:

WATCH OUT Suspicious Activity If something or someone looks suspicious, inform a college employee, campus administrator, or a security guard.

Campus Administration Office 758-7233/7471 or757-5187 or the Front Desk in the Registrar’s office 758-7265/7620/7366/ or 7641 Security at 682-9552/758-7777

Disruptive or threatening behavior Someone’s behavior may change for a variety of reasons, and help may be needed. Disruptive, unusual, and/or threatening behavior should be reported to available campus resources as follows:

Guidance Counsellors 758-7578/7479 Instructors Campus Administrators 758-7233/7471 or757-5187.

RESPONSE TO AN ACTIVE INTRUDER THREAT In the event of an immediate threat to the campus community, the Prince Philip Drive Campus will invoke their Active Intruder Plan as follows:

FIGURE OUT If a commotion arises that appears to be dangerous, trust your instincts. When safe to do so, investigate to determine what is happening around you and if you are in danger. Do not put yourself at risk!

GET OUT If you witness a person(s) with weapons and/or a situation where danger is imminent, consider your own safety first!

Determine if you can leave the area safely. If you have not been detected, and you have an escape route; then leave. Move

as quickly and quietly as possible to a safe area. Call 911. If you are unable to leave safely, seek shelter, and hide out.

HIDE OUT If you cannot leave your area safely, protect yourself by immediately seeking shelter and hiding in a secure location.

Inside the building

Clear the halls and open areas immediately; then move to nearest available room.

Close, lock, and/or barricade the door. Block the doors with desks/ chairs, etc. to make entry difficult.

Turn lights off, and maintain minimal lighting. If possible, cover all room and door windows. Lie on the floor away from windows and doors, and keep out of sight Remain calm and quiet, and do not attempt to leave. Do not unlock or open the door for anyone! The police and security will

unlock the doors once they deem the area to be safe.

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Comfort others who may be panicking, and assist anyone who may be injured. Where possible, take attendance of the room’s occupants. Make a plan in the event of intruder(s) gaining access to the room and you have

to stop the intruder. Do not leave the building if the fire alarm is activated unless directed by police

or security or if a fire is confirmed.

Outside the building Move quickly to a safe place to take cover and/or seek protection. Use whatever

cover is available for protection (trees, vehicles, etc.). Run, walk quickly, or crawl to safety. Try to put as much distance between you

and the active intruder(s).

GET THE WORD OUT One person should contact emergency responders by calling 911. Calmly provide

any essential information available such as the number of intruders, weapons involved, physical description of the intruder(s), location, etc. Keep a telephone line clear for communicating with emergency responders.

After that contact is made, call the: Campus Administration Office 758-7233/7471 or 757-5187 Front desk in the Registrar’s office 758-7265/7620/7366/ or 7641 Security at 682-9552/758-7777

Silence your cell phone, and use it for texting only. Telephones are only to be used to communicate critical information.

WAIT OUT Wait for police/security to unlock your door, assist you out of the building, or to

give you directions. Remember, do not unlock or open the door for anyone! When the police arrive, slowly show your hands, do not run towards them, wait

for them to approach you, and follow their instructions. The police do not know you, and they need to know you are not a threat. They

may handcuff you, search you, or ask you to remain still. These are routine measures until officers believe they have the situation under control.

POLICE RESPONSE The police are the primary responders to an active intruder incident. They may control entry, exit, and movement within the building. Officers may interview you and require your contact information.

Once the police have contained a situation, they may determine it is safe to evacuate the building. If the police call for an evacuation, carefully follow their instructions.

The police or a designated person will normally lead the evacuation. Move quickly in an orderly fashion taking a specified safe route. Help those requiring assistance. Do not interfere with any physical evidence.

ENDING THE ACTIVE INTRUDER PLAN Police and campus administration will decide when the Active Intruder Plan is to be ended. This information will be communicated following the same process as the Active Intruder Plan initiation and by a room by room confirmation by police and/ or security.

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FIRST AID/ MEDICAL EMERGENCY It is easier to handle a medical situation if you are prepared.

Be familiar with the location of the first aid kits.

Be familiar with the location and operation of eyewash stations and safety shower.

Learn first aid procedures by taking a first aid and CPR course.

Be familiar with the location of Automatic External Defibrillators at your Campus. (PPD -Security Office near the front entrance, gym and T.I.Murphy center in L-block)

When first aid required is beyond the scope of the individual:

Seek assistance from others that may be available and call Security office-758-7283.

State your name, where you are located, and extension number. Report the location of the accident – wing and room number.

Give extent of the injury and request an ambulance (depending on severity of injury).

If you cannot reach Security or the Campus Nurse (758-7289) and the injury is severe, call 911 and provide the following information:

o Name of reporter o Location in the building o Nearest entrance o Nature of the emergency

Notify Security that an ambulance has been called and request that someone wait at the entrance to provide direction to you once help arrives.

Remain at the scene until the arrival of the Emergency Response.

Complete an Incident Form (Appendix 1) or Needlestick/Biological Exposure Report Form (Appendix 2) as appropriate.

THERMAL BURNS Remove the casualty from the source of the burn.

Eliminate the source of the burn: smother the fire (Stop, Drop and Roll if clothing is on fire) or flood with water using the safety shower.

Immerse the burned area in cold water for 10 minutes to prevent swelling or blistering or place clean cloths soaked in cold water on the burned area if immersion in cold water is not possible.

Remove clothing or jewelry. Do not remove clothing that may be stuck to the burn.

Cover the burned area loosely with a clean, moist dressing or lint-free material. DO NOT cover the burn with cotton wool, tissues, paper towel or sticky material.

DO NOT apply lotions, oils or butter.

DO NOT break blisters.

DO NOT touch the burned area with your fingers.

DO NOT breathe or cough over the burn.

Arrange transportation to medical aid if necessary.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

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CHEMICAL BURNS TO THE SKIN Brush any dry chemicals off. Take care not to get the chemical in the eyes.

Flush the area with large amounts of cool running water immediately (have the person remove any chemically contaminated clothing).

Continue to flood the area for at least 15 minutes.

Cover the burned area with a clean dressing.

Arrange transportation to medical aid if necessary.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

CHEMICAL BURNS TO THE EYES Splashes of chemical materials onto the face or into the eyes must receive prompt and immediate first aid.

Brush any dry chemicals off the skin. Take care not to contaminate the other eye or skin.

Flush the eye with large amounts of cool running water for at least 15 minutes. Use eyewash station if available.

Never irrigate the eye with any chemical antidote.

Remove or flush out contact lenses if casualty is wearing any.

Arrange transfer to medical aid immediately.

Complete an Incident Form (Appendix 1).

CUTS Small cuts

Should be washed with soap and water.

Cover with an adhesive dressing or gauze.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

Cuts that are profusely bleeding

Apply direct pressure directly on the wound with a dressing (if available) or a clean gloved hand. If object is protruding from the cut, apply pressure around the cut.

Elevate the injured part, if possible, to help slow down bleeding.

Place the casualty at rest.

Do not remove blood-soaked dressings; apply another pad of dressings over them.

Bandage the dressings in place to maintain pressure on the wound.

If injuries permit, immobilize the injured part in an elevated position.

Arrange transfer to medical aid.

Complete an Incident Form (Appendix 1).

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NEEDLE STICK INJURY/ BIOLOGICAL EXPOSURE Despite the best efforts, accidental biological exposures can occur. A percutaneous exposure to body substances, either by a needle stick injury, a laceration, or a splash on mucous membranes or non-intact skin, has the potential to transmit blood borne pathogens to the exposed individual. Any suspected exposure to infectious/communicable diseases must be reported to the instructor immediately. Cuts/needlesticks and mucosal splashes involving material contaminated with human blood or body fluids must be seen immediately for a medical assessment regardless of how small the cut or puncture. It is not the role of the student to assess the seriousness of the exposure. Do not wait for an appointment with your family physician. Seek a medical assessment within 2 hours.

Administer First Aid Immediately:

Percutaneous– Needle sticks, puncture wounds or lacerations from used needle and sharp instruments.

Allow immediate bleeding of wound, wash injured area well with soap and water and apply antiseptic, if available.

Cutaneous – Any contact with broken skin. Remove contaminated clothing, wash area well with soap and water and apply antiseptic if available, to the open wounds.

Mucosal – Any contact with conjunctiva (eye membrane) or mucous membranes of the nose or mouth.

Splashes of biohazardous materials onto the face or into the eyes must receive prompt and immediate first aid by flushing the affected area with large amounts of water or. Prolonged irrigation is defined as at least 20 minutes.

Complete a Needlestick/Biological Exposure Report Form (Appendix 2).

Refer to Laboratory Acquired Infections section for additional information

FAINTING Place the casualty in the recovery position, if injuries permit.

Ensure a supply of fresh air; open windows or doors.

Loosen any tight clothing at the neck, chest, and waist.

Keep others away.

Reassure the casualty as they regain consciousness.

Keep the casualty lying down for 10 to 15 minutes. Once the casualty has recovered, have her/him get up slowly to prevent another incident. If the casualty is not feeling stronger, stay until medical help arrives.

Arrange transfer to medical aid as necessary.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

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ELECTRICAL SHOCK DO NOT PUT YOURSELF AT RISK.

If you can do so without putting yourself at risk, trip the circuit or remove the plug.

Inform Instructor/ Supervisor.

Seek assistance from others that may be available.

Assess breathing and pulse.

Request an ambulance (depending on severity of injury) by dialing 911, and/or call Security: Office—758-7283, Cell—682-9552, Pager—778-1710.

State your name and where you are located.

Report the location of the accident – building and room number and give extent of the injury.

Have someone notify security that an ambulance has been called.

Give CPR as indicated until an ambulance arrives.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

INHALATION OF GASES DO NOT PUT YOURSELF AT RISK

Only trained personnel with proper Personal Protective Equipment can safety enter a gas filled room.

Evacuate the area/ building if necessary

Call Security: Office—758-7283, Cell—682-9552, Pager—778-1710. If you cannot reach Security, call 911.

State your name and where you are located (room number).

Give extent of the injury including details about possible gas inhalation.

Have someone notify security that emergency services have been called.

Give CPR as indicated until an ambulance arrives.

Complete an Incident Form (Appendix 1). This is required whether or not additional health care treatment is required.

DO NOT PUT YOURSELF AT RISK

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ACCIDENT/ INCIDENT REPORTING – PPD Campus

Accident/ Incident reports are essential to Occupational Health and Safety and Health Services, particularly as they relate to identification of health and safety hazards in the College. Accident/Incidents Reporting Procedures for Accident/Incidents and for Accident/Incident Involving Needlestick/Biological Exposure are outlined below.

ACCIDENT/INCIDENT REPORTING NOTE: if the incident involved a needlestick or biological exposure refer to section below Accident/Incident Involving Needlestick/Biological Exposure

Action to be taken by student Action to be taken by Instructor

1. Seek First Aid and/or medical assessment as required.

2. Report incident to instructor immediately.

3. Complete an Incident Report Form (Appendix 1) 4. If necessary participate in any follow -up

investigation by college administration, and discuss return to program with Student Services.

1. Assist the student by administering first aid and/or obtaining a medical assessment.

2. Facilitate the completion of an Incident Report Form by student.

3. Submit the completed form to the Student

Services Nurse within 24 hours of the incident. (Mark envelope “Private and Confidential”)

4. If necessary participate in any follow -up

investigation by college administration

ACCIDENT/INCIDENT REPORTING INVOLVING NEEDLESTICK/BIOLOGICAL EXPOSURE

Action to be taken by student Action to be taken by Instructor

1. Report incident to instructor immediately.

2. Seek First Aid immediately (actons listed on page 19)

3. If possible identify source specimen 4. Seek a medical assessment within 2 hours if the

needle was contaminated with blood or body fluids. Contact Student Services Campus Nurse at 758-7289 or Cell Phone # 730-8725. NOTE: If the Nurse is not available proceed to the nearest Emergency Department within 2 hours.

5. Complete an Incident Report Form (Appendix 1)

and a Needlestick /Biological Exposure Incident Report (Appendix 2).

6. Follow up with medical treatment as directed by

the Emergency Department physician. 7. Follow up with Student Services Campus Nurse.

8. If necessary participate in any follow -up

investigation by college administration/and discuss return to program with Student Services

1. Assist the student by administering first aid

immediately (actions listed on page 19).

2. Assist student to obtain a medical assessment; either from Student Services Campus Nurse (758-7289 or Cell Phone # 730-8725) if available or proceed to the nearest Emergency Department within 2 hours of the incident.

3. Facilitate completion the Incident Report Form

and the Needlestick /Biological Exposure Incident Report Form.

4. Submit the completed form to the Student

Services Nurse within 24 hours of the incident. (Mark envelope “Private and Confidential” )

5. If necessary participate in any follow -up

investigation by college administration.

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GENERAL LABORATORY SAFETY Safety in the laboratory depends upon the cooperation of everyone in the laboratory at any particular time. Safety is everyone's responsibility. Most accidents in a laboratory are the result of carelessness or poor judgment either by the injured person or by a neighbor. Every individual who works in the laboratory must learn and observe the safety rules listed here. In addition, you should develop the habit of thinking beforehand about the possible risk in any experimental procedure. You should review the basic rules each week until you know them thoroughly. In any given laboratory period, you will be using reagents and equipment. Careless or thoughtless conduct by one student can result in injury, delays, errors, and poor results for an entire class. Always keep in mind potential dangers to yourself and to persons working with you. Students who arrive for laboratory sessions without appropriate clothing and required safety equipment will not be permitted to use the laboratory.

ACCESS TO LABORATORIES

The Health Science Department is committed to ensuring the safety and security of all persons using the teaching laboratory facilities within our department.

Laboratory access is limited to authorized persons only.

All visitors/ contractors must check with laboratory instructor/laboratory staff prior to entering the laboratory.

Only students currently registered for the course are permitted to attend the laboratory sessions.

The laboratory must be secured when not in use for laboratory or clinical activities.

Students must be supervised at all times while in laboratories. o The level of supervision required could vary from laboratory to laboratory

and will take into account the hazards associated with the tasks being performed, the level of training and expertise of those being supervised.

o When an activity is being introduced or the risk associated with an activity is high the students must be supervised directly by qualified personnel.

o When the student has demonstrated competency in a procedure/activity or the risk associated with the activity is low, then supervision may be indirect; provided the qualified personnel is in a position to assist immediately, if required.

ORIENTATION OF STUDENTS TO THE LABORATORY The student and instructor are required to document completion of the safety orientation on a Safety Orientation Checklist. Once the form is completed the instructor will keep it on file.

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GOOD LAB PRACTICE The use of good laboratory practices will reduce or eliminate the risks.

Be aware / Take care

Students MUST be supervised at all times.

Be on time for the laboratory session. Safety information and instructions are given at the beginning of the laboratory session; students arriving late will miss this information and may be refused entry to the laboratory.

Walk, never run.

Use caution when handling sharps (needles, syringes, etc.). Discard into an approved Sharps container.

Keep hands away from face, eyes and mouth.

Hazardous materials

Use MSDS (Material Safety Data Sheets)/ SDS (Safety Data Sheets) and PSDS (Pathogen Safety Data Sheets) to learn about the hazardous properties of chemicals and biological agents used in the workplace.

Observe safe handling, storage, disposal and emergency procedures.

Treat unknown materials as potentially hazardous.

It may be necessary for pregnant and/or immunosuppressed individuals to avoid and/or use extra precautions when handling certain chemicals and biological agents. Refer to MSDS/SDS/PSDS and discuss with your supervisor/instructor.

Knowledge of emergency procedures and equipment

Know the floor lay-out, location of exits and designated evacuation routes, exit procedures, sound of fire alarm, location of fire alarm pull stations and fire extinguishers.

Know the location of eyewash stations, showers, first aid kit and spill clean-up kits and telephone.

Personal protective equipment (PPE)/ Laboratory Attire

Wear appropriate PPE (e.g., lab coat or gown, gloves, safety goggles or face shield, and apron) for the work being conducted.

Wear a long sleeved lab coat with a closed front at all times when working in the laboratory.

Lab coats must remain in the laboratory when biological agents are being used.

Avoid wearing shorts or skirts; long pants that completely cover the legs are preferred.

Wear shoes with good grip soles, closed toe and closed heel; with heels not more than 1 ¼ “in height. Cloth shoes will absorb chemicals or infectious fluids and are not recommended.

Long hair must be tied back.

Restrain loose clothing and jewelry when working with chemicals, biohazards, flames or moving machinery.

Ingestion of hazardous materials

Food (including gum) and beverages are not permitted.

Do not apply lip salve or cosmetics in the laboratory.

Contact lenses are not permitted in laboratories where chemical and biological materials are present.

Do not insert fingers, pencils, etc., into the mouth or touch eyes, nose or mouth.

Routine practice/standard precautions must be used when handling specimens.

Practice good, regular hand washing techniques.

Wash your hands before leaving the lab.

Bandage open cuts and scratches on hands.

Dispose of biological waste in the appropriate containers.

Use only mechanical pipetting devices for pipetting. NEVER mouth pipette.

Use Biological safety cabinets (Class II) to process all clinical specimens and if there is potential for splashing/aerosolization during test procedures.

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Work area

Keep work area neat, organized and free of clutter.

Do not bring coats, books (not required for the laboratory), purses and other personal items into the laboratory.

Do not store outerwear or personal belongings in the laboratory. Store these items in a secure place, e.g. lockers.

Clean and decontaminate work surfaces before and at the end of each laboratory session.

All equipment used should be returned to the storage areas after use unless directed otherwise.

Keep lab corridors and exits free of obstructions and tripping hazards.

Biological Containment Level 2 labs must have dedicated clean areas within the containment zone and follow work practices to minimize the contamination of paperwork.

Chemicals

Handle all chemicals with care.

Never smell or taste chemicals.

Ensure all bottles of chemical and prepared solutions are clearly labeled.

Conduct procedures using volatile, toxic or flammable chemicals in a chemical fume hood. Check MSDS/SDS.

Dispose of chemical waste in the appropriate containers.

Equipment

Check the safe working condition of all equipment before operating it.

Report any equipment malfunction, label and remove any faulty equipment from service.

Never leave laboratory reactions unattended.

Turn off equipment at the end of the session as directed by instructor.

Accidents/ Incidents

Report all accidents, incidents and adverse health effects related to working in the laboratory to your instructor as soon as they occur

Immunization

Individuals working with biological agents should be protected by appropriate immunization and antibody levels documented.

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PERSONAL PROTECTIVE EQUIPMENT Use of personal protective equipment will minimize the risk of exposure or contact with biological or chemical hazards.

PPE PROCEDURE PRECAUTIONS Lab coat Medical Laboratory Technology Program Applies to all Containment Level II labs and Histology lab

Wear an appropriate long sleeved lab coat with a closed front at all times when working in the laboratory.

Lab coats must be stored in the laboratory area.

Lab coats must not be removed from the laboratory area.

Lab coats from these areas are cleaned by a laundry service.

Remove the lab coat worn in the laboratory prior to exiting the work area or entering office areas.

Place soiled lab coats in laundry bags provided.

If a lab coat becomes grossly soiled with biological material or hazardous chemicals, remove it immediately and place it in a suitable bag for treatment prior to sending for laundry.

If the contamination is from highly toxic or corrosive material it may be necessary to dispose of the lab coat as hazardous waste.

Lab coat Academic labs (Biology, Chemistry)

Wear an appropriate long sleeved lab coat with a closed front as required when working in the laboratory.

Lab coats may be removed from the laboratory area unless they have been contaminated with chemicals or biological material.

Students are responsible for storage and cleaning of their lab coats.

Lab coats should be washed separate from other clothing. It is recommended that hot water, a suitable laundry detergent and bleach be used.

Remove the lab coat worn in the laboratory prior to exiting the work area or entering office areas.

If a lab coat becomes grossly soiled with biological material or hazardous chemicals remove it immediately and place it in a suitable bag for treatment prior to leaving the laboratory.

If the contamination is from highly toxic or corrosive material it may be necessary to dispose of the lab coat as hazardous waste.

Gloves Wear non-latex disposable gloves when handling biological specimens and performing procedures on “patients”

Neoprene gloves may be required for some chemical handling; check MSDS/SDS for specifics.

Wear insulated gloves when handling hot or cold material.

Metal mesh gloves should be worn for protection from cuts when gross sectioning tissue for processing.

Do not handle “clean” items such as phones or computers while wearing gloves.

Do not touch your face/hair or clean areas with gloves on.

Always wash your hands after removing gloves.

Gloves used in biological material handling are to be disposed of in biohazard bags.

Laboratory personal must be trained in appropriate use/removal/disposal of gloves (see Routine Practices/ Standard Precautions).

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PPE PROCEDURE PRECAUTIONS Eye and face protection

Safety glasses or goggles must be worn at all times in many college laboratories, particularly when chemical, biohazardous material and open flames are used. Your instructor will advise you of the requirements in your laboratory.

Safety glasses or goggles must be worn over prescription glasses and must have side shields.

Protective eyewear and masks or face shields must be worn to prevent exposure of mucous membranes of the eyes during procedures which could involve splashing or generation of droplets of blood or other body fluids.

Contact lenses are not permitted in areas where chemical or biological hazards are present.

If not disposable, then the face shields should be removed and cleaned with soap and water or suitable disinfectant after each use.

Disposable face shields DO NOT provide suitable eye protection for chemical use.

Footwear Must be closed toe and closed heel.

Cloth shoes will absorb chemicals or infectious fluids and are not recommended.

Where there is danger of crush or puncture injury to the feet, wear safety footwear that meets CSA standards.

Wearing shoes with open toes and/or heels and sandals are not permitted.

Shoes with non-slip soles should be worn, especially in areas where paraffin wax is used or the floor may be wet.

Masks N95 masks are required for airborne infectious agents.

Surgical masks may be needed to avoid contaminating cultures, etc. if personnel have a cough.

Fit testing is required for N95 masks.

Surgical masks do not offer appropriate protection against aerosolized biological agents.

Respirators Respirators may be required for cleanup of chemical spill. Check MSDS.

Respirator must be appropriate for the hazard.

Respirator users must be fit tested and trained in use.

Respirators must be maintained.

Must follow CSA std Z94.4-02, "Selection, use, & care of respirators".

Specific programs may have specific requirements which your instructor will discuss with you.

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SAFETY EQUIPMENT

EMERGENCY WASH STATION

Eyewash

Know the location of eyewash station and how to use them.

If eye protection fails, go to eyewash station.

Plastic covers will pop off when water is turned on.

Wash eyes / face continuously for 15 min, to prevent serious damage to the eyes.

For Biological Exposure flush for 20 min.

Seek medical attention immediately thereafter.

Emergency showers

Know the location of emergency showers and how to use them.

Every laboratory must be equipped with or have ready access to a safety shower.

They are located near potentially hazardous areas.

In case of chemical burns, go to nearest shower.

For ceiling shower, pull handle to activate.

Shower, washing affected areas, for 15 min.

Seek medical attention immediately thereafter.

CHEMICAL FUME HOODS

Fume hoods are provided and are to be used whenever there is risk of hazardous fumes. All fume hoods are inspected and certified annually. Chemical fume hoods are enclosed units with a front sliding sash for opening and closing the hood. If used and maintained properly the fume hood will offer protection from hazardous fumes. Before beginning work in a Fume hood

Ensure that the hood is working. Turn on the blower and wait 2-3 minutes for the blower to reach maximum velocity before commencing work in the hood. If the hood does not have a velocity indicator attach a piece of tissue paper to the hood opening to indicate whether the hood is functioning or use a velocity meter to obtain reading.

Check baffle location. The baffles are located in the back of the hood and direct air in the appropriate direction. Standard baffle set up for most operations is in the middle position. There must be at least 1 to 2” opening for the lower baffle. For high vapor density (e.g. chloroform) the baffles must be adjusted to draw more air from the bottom of the hood. If the chemical is lighter than air the baffles must be adjusted to draw more air from the top of the hood.

Working in the Fume hood

Only materials being used for the ongoing test or experiment should be in the fume hood.

Operate with the sash in the lowest position possible.

Work with your hands as far into the hood as possible; at least 15 cm.

Work with your head outside the hood.

Minimize movements in and out of the hood. Such movements will create disturbances of the air flow and reduce the effectiveness of the hoods’ operation.

NOTE: If the hood is equipped with an alarm and it sounds (a red light and audible alarm) during operation, stop work, close sash, turn off the hood, and notify instructor/supervisor.

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CHEMICAL FUME HOODS(Continued)

Upon completion of work in the Fume hood

Remove equipment and material from hood

Clean working surface

Return sash to closed position.

Turn off blower unless directed otherwise.

EQUIPMENT SAFETY

HEAT PRODUCING DEVICES (BUNSEN BURNERS/ HOTPLATES/ MICRO-INCINERATORS) Open flame should not be lit if any flammable liquids (e.g. alcohol, acetone) are

nearby.

Maintain a clear work area around all heat producing devices.

Do not use an open flame to heat flammable liquids.

Do not leave the burner or heater unattended.

Turn off and unplug the burner or heater when not in use.

Use care in handling hot waxes, base plates and other heated material.

GLASSWARE Keep your glassware clean. Using dirty equipment is not only a careless technique,

but might also result in the production of undesirable side-products or colors. Wash each item of equipment after use.

Never hold glassware by the neck; use two hands to support the bottom and sides of the container.

Do not use cracked or chipped glassware.

Use a dust pan and broom to pick up broken glass, not your hands.

Dispose of broken glass in a glass disposal container. Never dispose of glass in regular waste containers.

PIPETTE

Never pipette by mouth. Always pipette using a rubber bulb or a pipette aid.

Take care not to contaminate the rubber bulb or pipette aid.

SIMULATION EQUIPMENT/ MANIKINS Only people trained on the simulation equipment should use the equipment.

Unless directed otherwise gloves must we worn when working with manikins in a simulated environment.

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STAIR CHAIR

Always takes two persons to lift.

Allow students to go up/down stairs one step at a time.

UP: Person at head does lifting; person at feet does guiding.

Ensure person at feet is not tipping chair back toward the person at the head.

DOWN: Person at head and feet are both guiding. Allow chair to “roll” gently down step.

Must use spotter. Spotter will place one hand on the lower back of the person at the feet.

Spotter’s job is to keep persons back secure and count stairs. Spotter is used up and down.

Students must be supervised at all times.

STRETCHERS SCOOP STRETCHER

o When stretcher is occupied, always lift with two people. o Ensure student is stepping on bare floor when lifting. o Ensure Ambulance Stretcher is nearby – no walking with the scoop stretcher

while it is occupied. o Students must be supervised at all times.

AMBULANCE STRETCHER o When stretcher is occupied, always lift with two people. o Lift with legs – not back. o Person most familiar with stretcher should be at feet (in control of handles). o Students MUST be supervised at all times.

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WASTE DISPOSAL Laboratory waste disposal requires well defined procedures to prevent exposure to hazardous materials. Improper disposal of sharps, needles, glass, biomedical waste and chemicals put students, instructors, staff and waste handlers at risk. The following procedures should be implemented by all lab personnel. Instructors are responsible for ensuring that all students are trained and familiar with these disposal procedures and that all laboratory procedures are in compliance with these requirements. Laboratory waste categories:

Chemical

Biomedical

Broken glass

Non-hazardous

CHEMICAL WASTE Chemical Waste requires special handling and must be identified and collected at the point of use in appropriate containers. Chemical waste includes, but is not limited to:

Flammable solvents (acetone, alcohol, xylene)

Halogenated solvents

Toxic and poisonous material (phenol, formalin, lead or heavy metal compounds)

General directions

Do not dispose of chemical waste down the drain or with the regular garbage.

Each laboratory should have a designated area for chemical waste.

Do not overfill container (70-80% full only). Before adding waste to collection containers check the level in the container. DO NOT overfill.

Do not mix different chemicals or solutions.

If in doubt as to correct disposal procedures, contact the instructor.

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BIOMEDICAL WASTE Biomedical Waste requires special handling and must be identified and collected at

the point of use in appropriate containers.

Each laboratory area must have a designated, clearly labeled area for placement of biomedical waste.

Types of packaging

Example/ Packaging

Microbiology Waste

petri dish cultures autoclave bag (double bag or place in autoclave pan)

tubed cultures test tube rack in autoclavable pan

inoculating loops, applicator sticks, swabs and slides

puncture resistant container (place in autoclave)

specimens: swabs, sputum, etc., excluding urines

autoclave bag

Biologically contaminated waste

non-sharp, solid waste: gloves, kimwipes, tissue, paper towel, sponges

autoclave bag

glassware and plasticware: analyzer cups, Kova system™ components, pipet tips, transfer pipets, microscope slides and disposable test tubes

puncture resistant container

broken glassware autoclavable tray

Description Comments Autoclave bag

Do not fill more than 2/3 full.

Tie loosely.

Autoclave bags should be used for solid, non-sharp, hazardous biological waste only.

Autoclave bags must not be used for any other purpose.

Sharps Containers

Do NOT fill beyond mark indicated on label.

Report any inappropriate disposal of sharps to your Instructor/Supervisor. An Incident report (Appendix1) must be completed.

Never force material into the container.

Needles must NOT be recapped or be removed from disposable syringes.

Never place your hands in a sharps container.

Puncture resistant plastic container

Do not over-fill.

These containers must NOT be used for needles or sharps.

Must be labelled with Biohazard symbol.

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Human blood and body fluid waste

items visibly contaminated with blood autoclave bag or puncture resistant container

tubes of blood or blood products sealed tubes: rack or puncture resistant container open tubes: puncture resistant container

urine autoclavable tray

controls and other commercial material prepared from human products

depending on product autoclave bag or puncture resistant container

Used needles and sharps

needles, scalpel blades, lancets and syringes

approved sharps waste container

BROKEN GLASS Definition Non-contaminated intact or broken glassware. (For contaminated glass

use Biological Waste or Chemical Waste procedures.)

Examples Microscope slides, test tubes, beakers.

Packaging Glass disposal box.

Broken glass must NEVER be placed in regular garbage.

NON-HAZARDOUS WASTE

Definition Items that can be safely disposed of in landfill.

Examples Wrappers, packaging material, plastics, paper towel, tissues and any non-sharps that have NOT come into contact with biological agents.

Packaging Clear, green or black garbage bags.

Do not over fill boxes

Use bench-top size boxes for microscope slides.

Glassware must be free of chemical and biological contamination and should be dry.

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CHEMICAL SAFETY Route of Entry

There are four ways in which a chemical can enter the body:

Inhalation – breathing in gases, vapors and aerosols/particulate material

Absorption - through the skin or mucous membranes

Ingestion - directly or indirectly by way of contaminated food or drink or hand to

mouth contact (nail biting, smoking, chewing gum or using cell phones)

Injection - through needles or contaminated sharps

WHMIS WORKPLACE HAZARDOUS MATERIALS INFORMATION SYSTEM WHMIS Regulation requires that information about hazardous products in the workplace be communicated though the following:

Labels Material Safety Data Sheets (MSDS)/ Safety Data Sheets (SDS) Education and Training

WHMIS requires that all hazardous products be labeled and an MSDS/SDS for every hazardous product used in the workplace be readily available. WHMIS requires that all workers who work with or around hazardous products be trained and knowledgeable regarding the safe handling, storage and disposal of the products they may use or encounter.

EDUCATION & TRAINING Students All Health Science students enrolled in courses where hazardous materials are used are required to provide proof of WHMIS training prior to starting the laboratory sessions by presenting certificate to the laboratory instructor on or before the first lab session. It is not necessary for the instructor to keep copy of the certificate, they can track that the document was presented on a class list. Some program areas have completion of WHMIS training as a component of the course curriculum and certificates will be collected at that time. WHMIS training is available online and a login code can be purchased from the college bookstore. Students who successfully complete the training must print the certificate showing that the program was successfully completed. NOTE: WHMIS courses completed at other post-secondary institutes or during employment may be acceptable. Students should check with their instructor.

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EXEMPTIONS

There are other products used in various workplaces, including laboratories, which might be considered hazardous but are exempted from WHMIS regulations. These include manufactured articles, products made of wood or tobacco, products packaged for consumer use, hazardous waste, and products governed by the federal acts for: explosives, food and drugs, pest control products, and radioactive materials. NOTE: In Feb of 2015 WHMIS regulations were modified to incorporate the Global Harmonized System (GHS). GHS is an international program to standardize hazard classification and communication. While many things remain unchanged, there are significant changes and new elements introduced in WHMIS 2015. They include: Hazard Classifications, Labels (pictograms, signal words, precautionary statements) and Safety Data Sheets (SDS) During the multi-year transition from WHMIS 1988 to WHMIS 2015, both systems will be in use. During this time it is important to be familiar with both systems and to remain extra vigilant when handling hazardous materials. Refer to MSDS/SDS and product labels for safe handling practices. If the product label is from WHMIS 2015 then you must use an SDS from WHMIS 2015; an MSDS from WHMIS 1988 is NOT acceptable. MSDS/SDS binders for the hazardous material are available in the laboratory and copies of pictograms from both WHMIS 1988 and WHMIS 2015 are posted in the work areas for easy reference. For additional information visit Canada’s National WHMIS Portal at http://whmis.org/ and the Center for Occupational Health and Safety at http://www.ccohs.ca

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LABELLING

Everyone working in the laboratory is responsible for ensuring that all chemicals are properly labeled as per WHMIS requirements.

WHMIS 1988 Label SUPPLIER LABELS

Information required MUST HAVE A HATCHED BORDER SURROUNDING

LABEL

All products (chemicals) that are controlled under the WHMIS Regulations must have a supplier's label affixed to the container.

I. Product identifier II. Hazard symbol(s) III. Risk phrase(s) IV. First aid measures V. Supplier identifier VI. Reference to a MSDS VII. Precautionary measures

WORKPLACE LABELS Information required

Label that is produced by the employer and applied to containers at the workplace.

Used when chemicals are transferred from their original container (supplier label attached) into a different (usually smaller) container.

Used when a chemical mixture or formulation is produced in the laboratory.

I. Product identifier II. Safe handling procedures III. Reference to a MSDS

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WHMIS 2015 Label

SUPPLIER LABELS

Information required All products (chemicals) that are controlled under

the WHMIS Regulations must have a supplier's label affixed to the container.

1. Product Identifier 2. Hazard Pictograms 3. Signal Words “Danger” or

“Warning” 4. Hazard Statements. 5. Precautionary Statements 6. Supplier Identifier 7. Safe Handling Precautions 8.Reference to SDS

WORKPLACE LABELS Information required

Label that is produced by the employer and applied to containers at the workplace.

Used when chemicals are transferred from their original container (supplier label attached) into a different (usually smaller) container.

Used when a chemical mixture or formulation is produced in the laboratory.

1.Product Identifier 2.Safe Handling Precautions 3.Reference to SDS

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MATERIALS SAFETY DATA SHEETS (MSDS) SAFETY DATA SHEETS (SDS) An MSDS/SDS is a technical document communicating the health effects of exposure to a product, hazard evaluation, protective measures and emergency procedures to the user. MSDS/SDS’s are provided by suppliers of controlled products or they may be generated in the workplace.

MSDS's includes (as per WHMIS 1988 requirements)

SDS's includes (as per WHMIS 2015 requirements)

Product information Identification

Hazardous ingredients Hazard identification

Physical data Composition/ Information on ingredients

Fire or explosion hazard First Aid measures

Reactivity hazards Handling and Storage

Toxicological properties Exposure controls/personal protection

Preventative measures Physical and chemical properties

First aid measures Stability and reactivity

Preparation information including date Toxicology

Ecological information

Disposal considerations

Transport information

Regulatory information

Other information including date of revision

Each laboratory must maintain an MSDS/SDS for all chemicals listed in the inventory. The MSDS should not have a revision date older than 3 years. SDS’s are to be updated by supplier whenever new information is available.

36

WHMIS CLASSIFICATION

WHMIS 1988

WHMIS 1988 CLASSIFICATIONS AND PICTOGRAMS

Class A Chemicals - Compressed gas Includes any product, material or substance contained under pressure such as compressed gases.

Class B Chemicals - Combustible and flammable material

Sub-divisions Combustible and flammable materials include the following sub-divisions:

B1 Flammable gases B2 Flammable liquids Examples: acetone, ethanol, and glacial acetic acid

B3 Combustible liquids B4 Flammable solids Example: magnesium ribbon B5 Flammable aerosols B6 Reactive flammable materials

Flammables or combustibles are materials that under standard conditions can generate sufficient vapor to cause a fire in the presence of an ignition source.

Class C - Oxidizing Materials Oxidizing materials include any compound that spontaneously emits oxygen either at room temperature or under slight heating. Oxidizing materials pose a serious fire and/or explosion risk in the presence of flammable or combustible materials. Many oxidizers may be highly corrosive or toxic. Examples of strong oxidizers include: chromic acid, sulphuric acid, potassium permanganate, and nitric acid.

Class D1 - Chemicals, poisonous and infectious material: Immediate and serious toxic effects Chemicals which may cause acute toxic effects are classified as D1 materials. Such materials may be fatal or cause permanent damage if they are inhaled or ingested, or if they enter the body through skin contact. Less toxic substances should always be selected if an alternative is available. Examples of D1 Chemicals: Ammonium oxalate, Chloroform, Crystal violet, Ethanol, Giemsa’s stain, Hydrochloric acid, Iodine, Methanol, Oxalic acid dehydrate, Potassium hydroxide and Sulfuric acid.

37

WHMIS 1988 CLASSIFICATIONS AND PICTOGRAMS (continued)

Class D2 - Chemicals, poisonous and infectious material: Other toxic effects

Class D2 chemicals are materials that are not immediately dangerous to health; however, repeated exposures may cause death or permanent damage over time. Many D2 chemicals will cause cancer, birth defects and sterility. Other D2 chemicals may be sensitizers, which produce a chemical allergy. When possible, eliminate Class D2 materials from the workplace and use substitutes. Examples of D2 Chemicals: Hexane. Acetone, Sodium phosphate dibasic, Isopropanol, Trichloroacetic acid, Boric acid, Xylene, Potassium ferrocyanide and some mounting media.

Class D3 - Chemicals, poisonous and infectious material: Biohazardous and Infectious material

Biohazardous and infectious materials are any organism (bacteria, viruses, fungi, parasites, etc) or its toxins, that have been shown to cause disease or are believed to cause disease in animals or humans. Biohazardous and infectious material may cause illness or death.

Class E - Corrosives Corrosives are materials which chemically react at the point of contact to cause visible (often burn-like) damage to tissue. Examples of corrosives include acids and bases.

Class F Chemicals - Dangerously Reactive Chemicals Dangerously reactive chemicals are materials that react rapidly with themselves or other materials to release relatively large amounts of energy. In some situations, the reaction may be violent enough to produce a detonation. Examples: dry picric acid and sodium metal

38

WHMIS 2015 WHMIS 2015 Pictograms

Gases under pressure

Flammable Pyrophoric Self-heating substances and mixtures Substances that when in contact with water, emit flammable gases Self-reactive substances and mixtures Organic peroxides

Oxidizer

Acute toxicity - harmful Skin sensitization Irritation (skin and eyes) Specific target organ toxicity- drowsiness or dizziness, or respiratory irritation Hazardous to the ozone layer

Acute toxicity (fatal or toxic)

Carcinogenicity Respiratory sensitizer Reproductive toxicity Specific target organ toxicity- Single or repeated exposure Germ cell mutagenicity Aspiration hazard

Biohazardous Infectious Materials

Corrosive (Skin, eyes, and metals)

Explosive Self-reactive (severe) Organic Peroxide (severe)

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WHMIS 2015 Hazard Classes

Hazard classes are a way of grouping together products that have similar properties.

They are divided into 2 groups:

Physical Hazards- based on physical or chemical properties of the product

Health Hazards- based on the ability of the product to cause a health effect

Each hazard class has at least one category. Categories are assigned a number (1, 2, 3,etc.) or a type (A.B,C, etc.) There may be sub- categories. Indicates the severity of the category. Category 1 is the greatest level of hazard

Class- Physical Hazards Flammable gases Flammable aerosols Flammable liquids Flammable solids

These four classes cover products that have the ability to ignite easily and the main hazards are fire or explosion

Oxidizing gases Oxidizing liquids Oxidizing solids

These three classes cover oxidizers, which may cause or intensify a fire or cause a fire or explosion.

Gases under pressure

This class includes compressed gases, liquefied gases, dissolved gases and refrigerated liquefied gases. Compressed gases, liquefied gases and dissolved gases are hazardous because of the high pressure inside the cylinder or container. The cylinder or container may explode if heated.

Self-reactive substances and mixtures

These products may react on their own to cause a fire or explosion, or may cause a fire or explosion if heated.

Pyrophoric liquids Pyrophoric solids Pyrophoric gases

These products can catch fire very quickly (spontaneously) if exposed to air.

Self-heating substances and mixtures

These products may catch fire if exposed to air. These products differ from pyrophoric liquids or solids in that they will ignite only after a longer period of time or when in large amounts.

Substances and mixtures which, in contact with water, emit flammable gases

As the class name suggests, these products react with water to release flammable gases. In some cases, the flammable gases may ignite very quickly (spontaneously).

Organic peroxides These products may cause a fire or explosion if heated.

Corrosive to metals These products may be corrosive (chemically damage or destroy) to metals.

Combustible dusts This class is used to warn of products that are finely divided solid particles. If dispersed in air, the particles may catch fire or explode if ignited.

Simple asphyxiants These products are gases that may displace oxygen in air and cause rapid suffocation.

Physical hazards not otherwise classified

This class is meant to cover any physical hazards that are not covered in any other physical hazard class. These hazards must have the characteristic of occurring by chemical reaction and result in the serious injury or death of a person at the time the reaction occurs. If a product is classified in this class, the hazard statement on the label and SDS will describe the nature of the hazard.

40

WHMIS 2015 Classes (continued)

Class- Health Hazards

Acute toxicity

These products are fatal, toxic or harmful if inhaled, following skin contact, or if swallowed. Acute toxicity refers to effects occurring following skin contact or ingestion exposure to a single dose, or multiple doses given within 24 hours, or an inhalation exposure of 4 hours. Acute toxicity could result from exposure to the product itself, or to a product that, upon contact with water, releases a gaseous substance that is able to cause acute toxicity.

Skin corrosion/irritation This class covers products that cause severe skin burns (e.g. corrosion) and products that cause skin irritation.

Serious eye damage/eye

irritation

This class covers products that cause serious eye damage (e.g. corrosion) and products that eye irritation.

Respiratory or skin

sensitization

A respiratory sensitizer is a product that may cause allergy or asthma symptoms or breathing difficulties if inhaled. Skin sensitizer is a product that may cause an allergic skin reaction.

Germ cell mutagenicity

This hazard class includes products that may cause or are suspected of causing genetic defects (permanent changes (mutations) to body cells that can be passed on to future generations).

Carcinogenicity This hazard class includes products that may cause or are suspected of causing cancer.

Reproductive toxicity

This hazard class includes products that may damage or are suspected of damaging fertility or the unborn child (baby).Note: There is an additional category which includes products that may cause harm to breast-fed children.

Specific target organ

toxicity – single exposure

This hazard class covers products that cause or may cause damage to organs (e.g., liver, kidneys, or blood) following a single exposure. This class also includes a category for products that cause respiratory irritation or drowsiness or dizziness.

Specific target organ

toxicity – repeated exposure

This hazard class covers products that cause or may cause damage to organs (e.g., liver, kidneys, or blood) following prolonged or repeated exposure.

Aspiration hazard This hazard class is for products that may be fatal if they are swallowed and enter the airways.

Biohazardous infectious

materials

These materials are microorganisms, nucleic acids or proteins that cause or is a probably cause of infection, with or without toxicity, in humans or animals.

Health hazards not

otherwise classified

This class covers products that are not included in any other health hazard class. These hazards have the characteristic of occurring following acute or repeated exposure and have an adverse effect on the health of a person exposed to it - including an injury or resulting in the death of that person. If a product is classified in this class, the hazard statement will describe the nature of the hazard.

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CHEMICAL HANDLING

Knowledge of hazards

Know the hazards associated with the materials you are using.

Review labels and MSDS/SDS.

Know emergency procedures.

Know the locations of safety equipment such as emergency shower, eyewash, fire extinguisher, fire alarm, and emergency phone numbers.

Personal practices

Do not eat, drink, smoke, chew gum, or apply cosmetics, (lipstick, etc) in areas where laboratory chemicals are used or stored.

Do not store food items in areas where chemicals are used or stored.

Wear long hair tied back.

Restrain loose clothing and remove jewelry when working with chemicals.

Wear shoes with good grip soles, closed toe and closed heel; with heels not more than 1 ¼ “in height. Cloth shoes will absorb chemicals or infectious fluids and are not recommended.

Contact lenses are not permitted in lab areas where biological material and chemicals are used.

Wear appropriate personal protective equipment including lab coat, gloves and eye protection.

Avoid wearing shorts or skirts; long pants that completely cover the legs are preferred.41

Do not smell or taste chemicals.

Do not pipet by mouth.

Always wash hands and other exposed skin after chemical use.

Keep containers closed except when in use, including waste containers

Using Chemicals

When using a chemical for the first time, read the label carefully and consult the MSDS/SDS.

Never force open or knock a chemical container.

Keep work areas clean and uncluttered, with chemicals and equipment properly labeled and stored.

Conduct a visual inspection of the container and its contents routinely to ensure that they are in good condition and properly labeled.

Read labels carefully. Use of the wrong chemical could cause a serious incident. Use in quantities and concentrations as directed.

Never return excess chemicals to stock bottle.

Waste chemicals should be collected in waste containers as per instructor’s direction.

Control of hazards

Use appropriate personal protective equipment.

Conduct all processes that may result in the release of toxic vapors, fumes or dust within the fume hood.

Do not leave potentially hazardous chemical processes unattended.

Handle and store laboratory glassware with care to avoid damage and dispose of any damaged glassware in an appropriate container.

Always wash used glassware and plasticware after use.

Report any spills to your instructor.

Storage of chemicals

Store large containers of hazardous liquids securely near floor but at a height that allows safe handling.

Minimize quantities of chemicals kept in the work area.

Store chemicals under appropriate conditions.

Any flammable liquids requiring refrigeration must be in an explosion-proof refrigerator.

Segregate chemicals by hazard class (e.g., flammable liquids, organic acids, oxidizers, reactive chemicals) and store separately in appropriate approved cabinets (Flammable, Corrosive).

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CHEMICAL HANDLING PRECAUTIONS

Compressed Gas/Gas under Pressure

Cylinder may explode if heated or damaged

Transport and handle with care

Store away from heat or fire

Consult MSDS/SDS

Refer to Section on Handling Compressed Gases Flammable & Combustible Materials

Use

Know the location of the nearest Class B fire extinguisher and fire alarm pull station.

Use in well-ventilated area or in a chemical fume hood.

Eliminate ignition sources such as open flames, operation of electrical equipment and static electricity from areas in which flammable or combustible materials are used or stored.

Ensure that areas in which flammable/combustible materials are used have appropriate sprinkler systems or fire extinguishers.

Never dispose of a flammable or combustible material down a drain.

Always wear proper personal protective equipment.

Consult MSDS/SDS.

Transport Use Neoprene bottle carriers, Styrofoam packing crates or spring closing safety cans.

Storage in laboratory

Minimize the quantity of these materials within the work area.

Use approved container with a spring-closing lid for storage of flammable liquids (except in exceptional and approved circumstances). Container is designed to safely relieve internal pressure when subjected to fire exposure.

Store in grounded flammable liquid storage cabinets or in vented cabinets under a chemical fume hood.

Store any solvents which must be stored in glass bottles in the vented cupboard under a chemical fume hood.

Never store flammable or combustible materials near oxidizing materials.

Label storage areas or cabinets clearly as DANGER - FLAMMABLE.

For storage of flammable liquids in refrigerators and freezers, use only explosion-proof refrigerators and freezers.

Bulk storage Flammable storage PPD Campus F123B (Inside F123)

Ensure that areas in which flammable/combustible materials are stored have appropriate sprinkler systems or fire extinguishers.

Bond and ground metal containers whenever filling, dispensing or storing flammable liquids.

Use portable safety cans whenever possible for storing, transporting, and dispensing flammable liquids.

Store bulk volumes of flammable liquids in a designated flammable storage room.

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Oxidizing Materials

Keep oxidizers away from combustible and flammable materials.

Store in designated areas only. Designated areas must be cool and dry.

Keep away from heat and sources of ignition.

Always wear proper personal protective equipment, including eye, face and hand protection.

Consult MSDS/SDS.

Keep container tightly closed.

Examples of incompatible chemicals:

Flammable liquids such as

Methanol

Organic acids such as acetic acid

AND Oxidizing materials such as

Sulfuric or nitric acids

Sodium hypochlorite

Potassium permanganate

Acutely Toxic Materials

Handle with caution.

Always wear proper personal protective equipment,

Consult MSDS/SDS.

Avoid inhaling by working in a well ventilated area or in a chemical fume hood.

Keep controlled drugs and chemicals such as cyanides in a locked cabinet.

Cover work surfaces with dry, absorbent plastic-backed paper, as appropriate. Dispose of after each procedure.

Wash hands and work surfaces thoroughly after handling.

Biohazardous and Infectious Materials

Wash hands after handling.

Wear appropriate personal protective equipment.

Use these materials in designated areas only.

Disinfect work area after handling.

Consult PSDS

Refer to Biological Safety and Handling Patient Specimens and Cultures sections

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Dangerously Reactive Materials

Indicate the date of purchase and date of opening on each container of peroxide forming chemicals. All peroxide forming chemicals (i.e. acetaldehyde) must be tested for peroxides or disposed of within one year of opening.

Store reactive chemicals in a cool, well ventilated, flameproof space away from flammables and combustibles, oxidizers and corrosives.

Handle with caution

Refer to MSDS/SDS Do not store together: Reactive materials such as those listed above AND

Flammables, combustibles, oxidizers and corrosives

Corrosive Materials

Use

Wear appropriate PPE, including laboratory coat and goggles or a face shield.

Consult MSDS/SDS

Limit the amount of corrosive chemicals at the bench to the amount required for testing or processes.

Keep containers tightly closed.

Use strong corrosives in a chemical fume hood.

Always add acid to water (never the reverse), and do so slowly, to avoid a violent reaction and splattering.

Ensure that eyewash and safety showers are readily accessible in areas where corrosives are used and stored. In the event of skin or eye contact with corrosives, immediately flush the area of contact with cool water for 15 minutes. Remove all affected clothing. Get medical help immediately.

Transport Use Neoprene bottle carriers or Styrofoam packing crates.

Storage in laboratory

Store strong corrosives in well ventilated areas away from flammable and combustible liquids and oxidizing agents.

Label cabinet clearly as DANGER - CORROSIVE.

Do not store strong alkaline solutions in glass containers as glass will be etched and leachate will enter the solution. This will contaminate the solution and may dangerously weaken the container.

Because glacial acetic acid is flammable, store separately from other acids such as hydrochloric acid, nitric acid and sulphuric acid.

Store acids separate from bases.

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CHEMICAL SPILL RESPONSE

A manageable spill is a situation in which an individual, who is competent and has been trained, can safely contain, clean up and dispose of the spill without risk to themselves or others. Students must report all spills to their instructor.

An unmanageable spill is a situation in which an individual is not competent, untrained or simply unable to safely contain, clean up and dispose of the spill without risk to themselves or others.

Small Spill

A small spill is defined as less than 1 litre with no toxic fumes/vapours.

1. Warn others in the immediate area. 2. Report spill to your instructor. 3. Attend to any person who may have been contaminated or injured. Administer

appropriate first aid. 4. If the spill is manageable the instructor may initiate the cleanup process, using items

found in Spill Kits, appropriate PPE and in accordance with the MSDS/SDS information.

Large spill A large spill is defined as more than 1 litre and/or with toxic fumes/vapours. 1. Notify your instructor immediately and notify all individuals in the immediate

vicinity of the spill. 2. It may be necessary to evacuate the area or building. 3. Attend to any person who may have been contaminated or injured. Administer

appropriate first aid. 4. Advise building manager and Campus administrator to access the situation.

IN ALL INSTANCES, IF IT HAS BEEN DETERMINED BY THE PERSON IN CHARGE

THAT A SPILL CANNOT BE HANDLED IN A SAFE, COMPETENT MANNER, OR, IF

THE NATURE OF THE SUBSTANCE CANNOT BE DETERMINED, THE USER WILL

ACTIVATE THE FIRE ALARM AND CALL 911 IN ORDER TO OBTAIN THE

ASSISTANCE OF EMERGENCY SERVICES.

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BIOLOGICAL SAFETY

A biohazard is defined as any organism and/ or toxin, known or suspected to cause human or animal disease. Biohazardous agents include viruses, bacteria, fungi, rickettsia, and parasites. These organisms can gain entry into the human body by accidental ingestion, breaks in the skin or through the mucus membranes.

ROUTE OF ENTRY Biological agents can gain entry into the human body by:

Skin and eye absorption (e.g. blood or body fluids are splashed or spilled into eyes

or non-intact skin).

Inhalation (e.g. aerosol particles).

Ingestion (e.g. aspiration through pipette, transfer to mouth from hands/ gloves).

Injection (e.g. puncture to skin from needles).

Note: Often chemicals and biological hazards are located in the same laboratory. Rules for chemical safety are outlined in the Chemical Safety section and are to be followed along with the safety rules for safe handling of biohazardous material as outlined in this section.

CONTAINMENT LEVELS The containment level refers to the minimum physical containment and the practices required to safely handle infectious material in the lab environment. All biosafety procedures must be strictly followed in these areas.

Containment Level 1 Laboratories A Containment Level 1 (CL1) lab is a basic laboratory where biosafety is achieved through operational and physical design features. The Biology lab at PPD is an example of a CL1 lab. Some of the key elements are listed below:

Cleanable work surfaces which are decontaminated regularly

Use of good microbiological practices including handwashing, hair tied back, appropriate footwear, etc

Safe work practices developed based on identified risks

Training in biosafety

PPE appropriate to the work being done

Good housekeeping

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Containment Level 2 Laboratories In a Containment Level II (CL II) laboratory, biosafety and biosecurity is achieved through operational practices and physical containment specific to the biological agent handled. Several areas used in the Medical Laboratory Technology program have been classed as CL II laboratories. Some of the key elements include:

All elements listed for CL I

Administrative Controls o Biosafety program management o Medical Surveillance Program o Biohazard worker Registration

Operational Procedures o Work practices o PPE use o Decontamination of waste o Emergency Response Planning

Physical Containment o Location o Surface finishes o Restricted access to laboratory

Biosafety Equipment o Biological Safety Cabinets (Class II)

Anyone working in a (CL II) laboratory must complete a Biohazard Worker Registration form. The form is to be completed prior to work with human pathogens, blood or body fluids. The forms will be filed with the Biological Safety Officer (BSO) Note: One form for all (CL II labs) is acceptable. Do not need one for each lab

ROUTINE PRACTICES/ STANDARD PRECAUTIONS Routine practices are a set of infection control strategies and standards designed to protect workers from exposure to potential sources of infectious diseases. Routine practices are based on the premise that all blood, body fluids, secretions, excretions, mucous membranes, non-intact skin or soiled items are potentially infectious. These practices, while mainly adopted by healthcare providers, apply to all professions in which workers may become exposed to infectious microorganisms through contact with blood and body fluids. (Source CCOHS)

Definitions: (source CCOHS)

Universal precautions are a set of strategies developed to prevent the transmission of

blood borne pathogens. The focus of universal precautions is on blood and selected body fluids such as cerebrospinal fluid, pleural fluid, and amniotic fluid. Body secretions such as urine, vomitus, feces, or sputum are not controlled under universal precautions, and are instead usually covered under a set of guidelines called body substance isolation.

Routine practices are a combination of universal precautions and body substance isolation. Routine practices have a much bigger scope and aim to protect against the transmission of all microorganisms through contact with all body fluids, excretions, mucous membranes, non-intact skin and soiled items in addition to precautions for blood.

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Standard precautions is a term widely adopted in the United States and convey the same set of principles as routine practices.

There are 5 major components to routine practices. They are risk assessment, hand hygiene, personal protective equipment, environmental and administrative controls. In addition to routine practices, some situations require additional precautions to prevent

and control specific infectious agents based on the mode of transmission -- contact,

droplet, and airborne.

RISK ASSESSMENT (source CCOHS)

Before any task is performed, conduct a risk assessment to evaluate the risk of disease transmission. The risk assessment should take into account the following: •Time it takes to complete the task. •Type of body fluids that the worker may come into contact with. •Presence of microorganisms in the bodily fluids. •Route of potential exposure to these microorganisms. •Susceptibility of the worker to these microorganisms. •Environment in which the task is carried out. Appropriate strategies such as hand hygiene, waste management, and the use of personal protective equipment are then selected to reduce the risk of exposure and disease transmission.

HAND HYGIENE Hand hygiene is the act of removing or destroying microorganisms on the hands while maintaining good hand integrity (keeping the skin healthy). Hand hygiene can be performed with an alcohol-based hand rub or with soap and water.

Wash your hands before:

Beginning work

Direct patient contact

Leaving the laboratory

Going to the washroom

Wash your hands after:

Contact with biological material

Removal of gloves

Direct patient contact

Going to the washroom

Soap and Water Hand Washing: Use a designated hand wash sinks equipped with soap and disposable towels. 1. Remove all hand and wrist jewelry. 2. Stand near sink, avoid touching it as the sink itself may be a source of

contamination. 3. If using a lever-operated paper towel dispenser, dispense a portion of towel before

washing hands. 4. Turn on water and regulate flow of water so that temperature is warm (avoid using

hot water as repeated exposure to hot water may increase risks of dermatitis). 5. Wet hands and wrists thoroughly under running water (soap sticks to water and not

skin). 6. Apply a small amount of soap, lathering thoroughly for at least 15 seconds.

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Soap and Water Hand Washing (continued) 7. Interlace fingers and rub palms and back of hands with circular motion. 8. Rinse hands and wrists thoroughly under running water. 9. Pat hands dry with disposable paper towel. 10. Use paper towel to turn off faucet to prevent contaminating your hands. General direction for the use of Alcohol Based Hand Rub:

Alcohol based hand rub (ABHR) can be used when hands are not visibly soiled.

ABHR must not be used as hand hygiene for patients with Clostridium difficile infection as it is not an effective agent.

ABHR must contain a minimum of 70% alcohol. 1. Remove all jewelry from hands and wrists. 2. Apply enough ABHR rub to cover the entire surface of hands and fingers. 3. Rub the solution into hands until dry (approximately 30 seconds).

PERSONAL PROTECTIVE EQUIPMENT (PPE) PPE includes gloves, lab coats, goggles, masks, face shields etc. PPE is particularly needed when disease transmission may occur through touching, spraying, aerosolization, or splashing of blood, bodily fluids, mucous membranes, non-intact skin, body tissues, and contaminated equipment and surfaces. PPE can help create a barrier between the exposed worker and the source of microorganisms. Gloves Gloves are a very common sight in most clinical and laboratory settings, however keep in mind that gloves do not provide absolute protection from exposure to infectious material. Gloves do not take the place of hand washing. Gloves often create a moist environment that facilitates the growth of microorganisms. Hands should be properly washed after the gloves are removed.

Medical examination gloves should be worn when:

Direct or indirect contact with blood and body fluids might occur. o Direct contact includes intubation, trauma assessment, suctioning, etc. o Indirect contact includes specimen handling, disposal of garbage, cleaning of laboratory

benches, etc.

Contact or potential contact with mucous membranes or non-intact (cut, cracked or abrasions) skin of patient may occur.

For your protection if your hands have cuts, scratches or broken skin.

Handling equipment and instruments that have been in contact with blood or body fluids.

Gloves must be changed:

Between contact with one patient and before contact with another.

When they are torn, punctured, cut or grossly contaminated and periodically throughout the day.

During patient care if moving from contaminated area ( i.e. Infected wound care) to a clean area ( i.e. setting up an IV).

Precautions when wearing gloves:

To reduce the risk of punctures, keep fingernails short and avoid wearing artificial nails, rings or wrist jewelry.

To protect open scrapes on your hands. A small cut may be covered by a water-impervious bandage.

Do not reuse, wash or disinfect disposable gloves.

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Precautions when wearing gloves (continued)

When wearing gloves, do not touch your face/ hair or clean areas (e.g. the pockets in street clothes worn under a lab coat or gown).

Remove gloves before handling pens, pencils, phone or a computer keyboard. ( In some areas special procedures are required; your instructor will provide specific details).

Remove gloves before exiting the laboratory or patient care area.

Removal and Disposal of Gloves 1. Without touching the skin, take hold of the outside of the cuff of one glove with the

fingers of the other (gloved) hand.

2. Pull the glove down over the fingers. Continue to hold the glove after it is removed.

3. With the index and middle fingers of the ungloved hand, grasp the inside of the glove on the other hand.

4. Pull the glove down over the fingers without touching the outside of the glove and pull

over the removed glove. One glove will now be inside the other.

5. Drop both gloves into a waste receptacle. In Medical Laboratory Program areas all used gloves are disposed of in biohazard bags.

6. Wash your hands. Eye Protection, Faceshields and Masks Protective eyewear/ faceshields must be worn to prevent exposure of mucous membranes of the eyes during procedures or in close proximity to procedures which could involve splashing or generation of droplets of blood or other body fluids. Some program areas will require personnel be fit tested for and will use NIOSH N95 masks if there is risk of contact with airborne infectious agents.

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Donning and Doffing PPE The terms donning and doffing are often used with PPE. Donning is the procedure of assembling PPE on the user. PPE should be carefully inspected for damages prior to donning. Doffing is the procedure for removal of PPE and it must be done carefully to minimize any contamination of the skin or hair. The PPE donning/ doffing order when using gloves and lab coats is listed below. If addition PPE is used in your area your instructor will provide specific information regarding donning and doffing order.

Do

nn

ing

Ord

er

←

Single Gloves and Lab Coat Double Gloves and Lab Coat

Do

ffin

g O

rde

r

→

Lab coat (properly fastened) Gloves

Inner gloves Lab coat (properly fastened) Outer gloves

ENVIRONMENTAL CONTROLS (source CCOHS)

Environmental control refers to controlling and minimizing the level of microorganisms in the environment. Environmental control measures include: •Consistent and stringent equipment and work area cleaning, including laundry

protocols and schedules. •Proper disposal of waste such as sharps, biomedical, and pathological waste. •Appropriate ventilation and other engineering controls. •Installation of easily accessible and clearly identified waste containers, hand hygiene

product dispensers, and dedicated hand wash sinks. •Effective placement and segregation of sources of contamination.

ADMINISTRATIVE CONTROLS (source CCOHS)

Administrative controls include employee training, supervisory competency, immunization, cough etiquette, workplace policies and procedures that are strictly enforced, and sufficient staffing. Administrative controls are critical to ensure that the principles of routine practices are effectively and properly executed in the workplace.

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USE AND DISPOSAL OF SHARPS Punctures and cuts are common injuries among health care workers who handle sharp objects such as needles, transfer pipettes, scalpels, capillary tubes and broken glass. These sharps related injuries may lead to a serious or even life threatening infection if the object causing the puncture is contaminated with blood, blood products, or other body fluids from patients with bacterial or viral infections.

Needles, lancets and syringes must be disposed of in an approved Sharps Waste container.

Needles must not be recapped or be removed from disposable syringes.

Never force material into the container. When contents reach the fill line, seal the container and inform the instructor.

Never retrieve items from nor place your hands in a sharps container.

Do not fill beyond mark indicated on label. Filling beyond 2/3 of the container’s capacity increases the risk of injury.

Never attempt to catch falling objects such as knives, scalpels, and scissors.

STERILIZATION AND DISINFECTION HEAT STERILIZATION Generally heat sterilization (autoclaving) is regarded as the most reliable form of decontamination. Where required all instruments and material are sterilized prior to use. All biological contaminated material must be autoclaved prior to disposal or removed by a licensed waste disposal contractor.

DISINFECTANTS Instruments and material that cannot withstand sterilization can be surface-decontaminated with chemical disinfectant.

Some classes of disinfectants used are:

Chlorine compounds (sodium hypochlorite/Bleach)

Iodine preparations (Iodophor, Bridine)

Alcohol (isopropyl alcohol)

Hydrogen peroxide (Accel TB)

Program specific requirements will be obtained from your instructor.

INSTRUMENTS AND EQUIPMENT Disposable equipment and instruments should be used whenever possible. All reusable equipment or instruments that have been in contact with blood, other body fluids or mucous membranes must be decontaminated after each use. Thorough decontamination is essential before allowing service technicians to examine or repair an instrument.

Program specific requirements will be obtained from your instructor.

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WORK AREA Decontaminate all surfaces exposed to blood or body fluids at the beginning and the end of the laboratory session or more frequently if spills or breakage occur.

Program specific requirements will be obtained from your instructor.

HANDLING OF PATIENT SPECIMENS AND CULTURES In laboratory sessions requiring the use of blood, urine or other biological samples introductory level students are required to use their own blood, saliva and urine. Advanced level students could be permitted to handle biological specimens from others. Students in clinical placement will be expected to handle biological material as required to complete required competencies.

Refrigerators and freezers used to store biological material must be clearly labeled with a biohazard symbol. These units are not to be used for the storage of food or drink.

When uncapping a sample you should cover the cap with a gauze square or a wipe to prevent spillage. The cap should also face away from you. This procedure must be performed in a Biological Safety Cabinet or behind a shield as appropriate.

Pipettes should not be left in specimen containers as this increases the risk of accidentally knocking over the rack.

Whenever possible plastic transfer pipettes or automatic pipettors with disposable tips should be used to transfer or measure serum or other fluids. Never pipette by mouth.

Work benches should be kept clean and organized at all times.

All discarded cultures/ specimens should be placed in the appropriate containers for disposal.

When processing blood and other body specimens, gloves, a mask and protective eyewear must be worn.

Refer to Pathogen Safety Data Sheets (PSDS) for additional information. Printed copies are in the PSDS binder in the Microbiology laboratory. Or download them from http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index-eng.php or get the free PSDS App for your mobile device.

PHLEBOTOMIES Gloves must always be worn for phlebotomy procedures.

Discard or disinfect tourniquets after each use.

Blood collection areas must be disinfected and decontaminated according to appropriate standards.

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SAFETY EQUIPMENT BIOLOGICAL SAFETY CABINET (BSC)*

Biological safety cabinets (BSC) are provided and are to be used whenever there is risk of infection by splatter or aerosolization. All biological safety cabinets are inspected and certified annually. Class II Biological Safety Cabinet This is a ventilated cabinet for personnel, product and environmental protection which provides inward airflow and HEPA-filtered supply and exhaust air. Class II cabinets are used for low to moderate risk biological agents. Operating Instructions (refer to the Equipment SOP specific to you made and model of BSC for complete operating instructions) Start Up Considerations

Check that the sash is at the appropriate height. Adjust stool height so that the user’s underarms are level with the bottom of the sash.

Check the pressure gauges to verify that readings are within the acceptable range.

If present, test the airflow alarm and ensure it is switched to the “on” position.

Confirm inward airflow by holding a tissue at the middle of the edge of the sash to establish that it drawn in.

Disinfect the interior surfaces with a disinfectant effective against the infectious material and toxins used in the laboratory, allowing an appropriate contact time. If a corrosive disinfectant is used, the surface should be rinsed with water after disinfection.

Assemble all materials required for manipulation and load into the BSC. Care should be taken not to overcrowd or block the front or rear grilles to prevent the appropriate airflow patterns from being compromised.

When there is significant potential for splatter or splashes to occur during manipulations of infectious materials or toxins, the work area should be lined with a plastic-backed absorbent pad.

Place aerosol generating equipment (e.g. vortex mixer, sonicator) towards the back of the BSC, without blocking the rear grille.

After loading material in the BSC, allow sufficient time for the air to purge and the airflow to stabilize before initiating work. This will be specified in the manufacturer’s instructions, and is generally 3-5 minutes

Working in the BSC

Perform operations as far to the rear of the work area as reasonable. Ensure that elbows and arms do not rest on the grille or work surface.

Avoid excessive movement of hands and arms through the front opening. Such movements disrupt the air curtain at the front of the BSC, which can allow contaminants to enter or escape the BSC. Arms should enter/exit the BSC slowly and perpendicular to the front opening.

Keep a bottle of an appropriate disinfectant in the BSC while work is performed to avoid having to move hands outside of the BSC.

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Working in the BSC (Continued)

Segregate non-contaminated (“clean”) items from contaminated (“dirty”) items. Work should always flow from “clean” to “dirty” areas. See figure below.

Material should be discarded in a waste container located towards the rear of the cabinet workspace. Do not discard materials in containers outside of the cabinet.

Decontaminate the surface of all objects in the BSC in the event of a spill. The work including the inside surface of the window, should be decontaminated while the BSC is still in operation.

Natural gas and propane should not be used in a BSC; sustained open flames (e.g., Bunsen burner) in BSC’s are prohibited. On-demand open flames (e.g., touch-plate micro burners) are to be avoided as they can create turbulence in the BSC, disrupt airflow patterns, and can damage the HEPA filter. Non-flame alternatives (e.g., micro incinerator, or sterile disposable inoculation loops) should be used whenever possible.

Work in a BSC should only be conducted by one person at a time.

Equipment creating air movement (e.g., vacuum pumps and centrifuges) may affect the integrity of the airflow and should not be used within the BSC.

Windows that open should be kept closed when the BSC is in use.

Respresentative Diagram of a Recommended Layout of Materials and Workflow inside a Biological Safety Cabinet (BSC).

Completion of Work in the BSC

Upon completion of work, allow sufficient time for the air in the BSC to purge (i.e., pass through the filter) before disrupting the air curtain by removing hands or unloading material from the BSC. The purge time will vary by model and can be up to several minutes.

Close or cover all containers.

Surface decontaminate items before removing them from the BSC.

Disinfect the interior surfaces of the BSC, including sides, back, lights and interior of the glass, with a disinfectant effective against the pathogens in use, allowing an appropriate contact time. If a corrosive disinfectant is used, the surface should be rinsed with water after disinfection to avoid corrosion of the stainless steel surfaces

Routinely remove the work surface and disinfect the tray beneath it.

Routinely wipe the surface of the lights within the BSC with a suitable cleaner or disinfectant (e.g. ethanol).

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Air Flow and Power Failure of BSC

If the air flow changes abruptly or the fan stops working due to a power failure:

1. Immediately stop all work and close all open containers within the hood; taking care not to create aerosols.

2. Close the sash fully and turn off the blower switch. 3. Remove lab coat, gloves and thoroughly wash hands 4. Affix a warning sign “OUT OF SERVICE- CAUTION BIOLOGICIAL HAZARD” to

the front of the cabinet.

When the power is restored or the unit has been serviced:

1. Turn on the power 2. Wait 30 mins to reduce airborne particulate. 3. Verify proper operation of the cabinet. 4. Use a suitable chemical disinfectant and cautiously wipe down the exterior of all

items in the cabinet 5. Disinfect the work surfaces.

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EQUIPMENT SAFETY

AEROSOLS Aerosols are minute droplets of solid or liquids suspended in the air. These droplets are created when a person coughs or sneezes or an invasive procedure is performed. Other ways aerosols are created is by splashed, spilled, or pipetted liquids. Aerosols can be released in high concentration during operation of mixers, shakers, etc. In microbiology the placing of a hot loop in a culture or into an open flame may create aerosols.

KEYBOARDS/ TELEPHONES

Keyboards and telephones in non-laboratory areas are designated as clean and should not be accessible to individuals engaged in laboratory work. In the event that such a worker needs to use these keyboards or telephone, they must remove their gloves and wash their hands before doing so. o For keyboards and telephones designated as clean, individuals handling

specimens, patient assessment, IV and medication administration or engaged in laboratory work must remove their gloves before using these keyboards or telephones.

o For keyboards and telephones designated as contaminated are to be used only with gloves. Cover keyboards with appropriate protective covers (skins). Decontaminate protective covers after gross contamination (visible or known

contamination) or at least weekly with an appropriate disinfectant.

PIPETTING DEVICES Take steps to minimize generation of aerosols (expel liquids down the side of the

tube).

Clean and disinfect pipettes and pipetting aids when contaminated and on a regular basis.

If the pipettor is contaminated internally, notify your instructor so the entire unit can be disassembled and decontaminated by lab personnel.

Shorter pipettes may be helpful for work in a biological safety cabinet.

CENTRIFUGE All centrifuges should have a safety interlock to prevent the units from being opened

while the rotor is operating.

Centrifuge Vacutainer™ tubes with stoppers intact. All other tubes must have a secure cap in place.

Use only centrifuges with sealed centrifuge buckets if uncapped tubes must be used.

Do not operate centrifuges in a biological safety cabinet.

When in use the inside of bowl must be cleaned daily by the operator and maintenance should be documented.

Any broken tubes or spills in the centrifuge must be reported to the instructor immediately.

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MICROTOMES Use safety guards.

Make sure microtome is in the locked position when positioning paraffin blocks.

Always lock the hand wheel when microtome is not in use.

Remove blades or knives when microtome is not in use.

Avoid distraction while working on a microtome.

Avoid using fingers to remove sections from knife; use a brush, forceps and a microscope slide instead.

CRYOSTATS

Keep cover closed during cutting.

Wear gloves when preparing frozen sections

Routinely decontaminate the cryostat.

Handle knives cautiously.

Lock the handwheel and place a guard over the knife when changing blocks.

BLOOD GLUCOMETERS/ GLUCOMETERS If blood glucose meters must be shared, the device must be cleaned and

disinfected after each use, per manufacturer’s instructions, to prevent carry-over of blood and infectious agents.

If the manufacturer does not specific how the device should be cleaned and disinfected, then it should not be shared.

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BIOLOGICAL SPILL RESPONSE In the event of a spill, competent and prompt action is necessary for immediate clean-up to reduce and eliminate the hazards present. Report all biological spills to your instructor immediately. Precautions:

Check for contaminated clothing, footwear and skin and take necessary precautions prior to attempting a clean-up.

Wear appropriate personal protective equipment (lab coat, gloves, face protector shield or goggles, etc.).

Any individual involved in the clean-up of a spill must determine the nature of the spill and the appropriate clean-up procedure before beginning clean-up. Consult PSDS if required.

If necessary use forceps to pick up any broken glass and discard into a contaminated sharps container.

Always wash your hands after handing a biological spill.

Incidents involving the spill of pathogens are to be reported immediately to the instructor and the Biological Safety Officer. An accident/Incident report form must be completed.

SMALL SPILL

1. Cover spill with paper towels to avoid splashing during the addition of disinfectant and encircle the spill to prevent spreading.

2. Gently flood the area with a dilute bleach solution (1:10 dilution of bleach (5.25% ppm of available hypochlorite)) with circular motion moving from the outside towards the centre.

3. Let stand for 30 minutes. 4. Remove the paper towels with forceps and dispose as biological waste. 5. Repeat steps 1-4.

LARGE BIOLOGICAL SPILL (possible aerosol formation)

1. Hold breath and move away from the spill. 2. Inform others, evacuate the area and close the door. 3. Notify Building Manager who will arrange for the HVAC system to be shutdown. 4. After 10-30 minutes, when aerosols have settled, enter the area to begin clean-up. 5. Proceed with the clean-up as per small spills.

CLEANUP OF SPILLS IN BIOLOGICAL SAFETY CABINET 1. Leave fan ON. 2. Follow procedure as per small spills substituting a suitable disinfectant (e.g. Accel

TB or equal) DO NOT USE BLEACH IN THE BSC. 3. If spilled material goes through perforated work surface or grills to the catch tray

below, pour disinfectant to dilute spill tenfold. 4. Let stand and proceed with the clean-up as per small spills.

BIOLOGICAL SPILL ON A PERSON 1. If aerosols are present, immediately notify others in the area that a biological spill

has occurred and remove the person from the area. 2. Remove contaminated clothing and place in biohazard bag for decontamination. 3. Wash the skin with water and disinfectant soap or use the emergency shower.

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BROKEN TUBE(S) IN CENTRIFUGE Immediately notify others in the area that a biological spill has occurred and if there are any hazards associated with aerosol release, everyone should immediately leave the area. 1. Turn OFF the centrifuge. 2. If the centrifuge has sealed safety buckets, proceed to step 7. If in unsealed cups,

notify others in the area and wait 30 minutes to allow aerosols to disperse or settle before opening the lid.

3. Slowly open centrifuge lid, remove all broken tubes, buckets, rotors, etc., place in a basin of non-corrosive disinfectant (let stand for time recommended for selected disinfectant) or place in a tray to autoclave.

4. Place any unbroken capped specimens in disinfectant for 60 minutes and then remove and rinse.

5. Wipe down the bowl of the centrifuge twice with disinfectant, rinse with water and dry.

6. All paper towels/ wipes used are disposed as biological waste. 7. Remove sealed bucket to biological safety cabinet. 8. If any tubes are broken, leave in bucket, replace lid of bucket loosely and autoclave

entire contents or place in disinfectant (steps 3-4).

IN ALL INSTANCES, IF IT HAS BEEN DETERMINED BY THE PERSON IN CHARGE

THAT A SPILL CANNOT BE HANDLED IN A SAFE, COMPETENT MANNER, OR, IF

THE NATURE OF THE SUBSTANCE CANNOT BE DETERMINED, THE USER WILL

ACTIVATE THE FIRE ALARM AND CALL 911 IN ORDER TO OBTAIN THE

ASSISTANCE OF EMERGENCY SERVICES.

LAB-ACQUIRED INFECTIONS (LAI) Individuals who work with infectious material (Containment II laboratories) are at risk of exposure to the material they handle and may develop an LAI.

You must be familiar with microorganisms you are handling.

You must complete the Laboratory Acquired Infections Course on the PHAC website.

Be aware of the signs and symptoms caused by the infectious material in use and use all necessary precautions to prevent exposure to or release of the infectious material.

Notify your supervisor/instructor if o any illness caused by or that may have been caused by infectious material in use o incidents involving infectious material o failure of containment systems.

All accidents/incidents must be reported on a Needlestick /Biological Exposure Incident Report (Appendix 2).

NOTE: The college is required to submit an exposure notification report to the Public Health Agency of Canada (PHAC) immediately following any human pathogen exposure or recognition of a disease that has or may have been caused by a human pathogen. Reports will include incident investigation, root cause analysis, and controls put in place to prevent further exposures. PHAC may require additional follow-up.

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COMPRESSED GAS HANDLING A compressed gas includes any product, material or substance contained under pressure greater than atmospheric pressure. Compressed gases may represent many hazards depending on the type of gas, i.e. toxic, flammable, corrosive, oxidizer or frostbite in the case of cryogenic gases. Compressed gas cylinders may also pose a serious physical hazard if handled improperly. Personal protective equipment must be worn when handling cylinders – eg safety footwear, and gloves. Consult MSDS/SDS for hazards, appropriate PPE, and handling requirements for the gas being handled.

Identification of Contents

Cylinder labels should always be clearly visible.

If the label is defaced, altered, or missing the cylinder should not be used.

Do not rely on color coding as a means of identification; cylinder colors vary from supplier to supplier, and labels on caps are not reliable because many caps are interchangeable.

If the labeling on the gas cylinder becomes unclear or defaced so that the contents cannot be identified, mark the cylinder "contents unknown" and contact the manufacturer regarding removal.

Image from Mosby’s Respiratory Care Equipment 8 th edition 2010

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Transportation

Before moving a cylinder, close the cylinder valve, remove the regulator, and replace the protective valve cap.

If protective valve caps are supplied, they should be used whenever the cylinder is transported and kept in place until they are ready for use.

Cylinders should only be transported on approved carts or other units designed for transporting cylinders, and secured by a chain or a strap.

For size 5 / size 3 (E. size / D size respectively) if approved cart or holder is not available cylinder may be transported cradled in a person's arms.

Cylinders must not be dropped, dragged, rolled, or allow to strike each other violently.

Cylinders must not be lifted by the cap or cylinder post.

Empty cylinders will still be under pressure. Handle with the same precautions as full cylinders.

Storage of Cylinders

All compressed gas cylinders in service or storage shall be secured in such a way that they will not be knocked over.

Gas cylinders of water volume up to 5.0 L may be stored horizontally. This would apply to our size 3 (D size) tanks.

Cylinders or equipment for handling oxygen shall be stored in a clean, ventilated area free of grease, oil, or other contaminants.

Cylinder valves shall be closed at all times, except when gas is actually being used.

If the cylinder is designed for use with a valve cap, the cap shall always be in place when the cylinder is not in use and in storage.

Away from flames, sparks or any source of heat or ignition.

Away from electrical circuits and electrical wiring where the cylinder could become part of the circuit.

Away from dampness, salt, corrosive chemicals or corrosive vapors. Corrosion may damage cylinders and cause their valve protection caps to stick.

Store cylinders in compatible groups. Identify them by signs to prevent confusion.

Store flammables separately from oxidizers

Store corrosives separately from flammables

Store full cylinders separately from empties

Mark empty cylinders EMPTY or MT.

Store liquefied flammable gas cylinders in an upright position or such that the pressure relief valve is in direct communication with the vapor space of the cylinder.

Do not store flammable gas cylinders with oxygen or nitrous oxide cylinders or adjacent to oxygen charging facilities.

Keep oxygen cylinders a minimum of six meters from flammable gas cylinders or combustible materials.

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Leaking Cylinder

Cylinder leaks are characterized by a hissing sound near the valve.

Tag leaking cylinders or cylinders with stuck valves and move to a safe, secure outdoor location. Clearly tag the cylinder as “UNUSABLE AND HAZARDOUS”.

If the contents are flammable, keep away from any source of ignition.

Inform the supervisor who will make the necessary arrangements with the supplier for removal.

Do not attempt to repair cylinder valves or their relief devices while a cylinder contains gas pressure.

Use of Compressed Gas Cylinders

Cylinders must not be handled with oily or greasy hands, gloves or clothing

Equipment connected to oxygen cylinders should be labeled oxygen use no oil.

Do not use cylinders for any purpose other than the transportation and supply of gas.

Wipe the outlet with a clean, dry, lint-free cloth before attaching connections or regulators. The threads and mating surfaces of the regulator and hose connections should be cleaned before the regulator is attached.

Always use the proper regulator for the gas in the cylinder. Always check the regulator before attaching it to a cylinder. If the connections do not fit together readily, the wrong regulator is being used.

Use only CSA approved hose and connectors. A standard is available, Gas Pipeline Systems, CAN-CSA Z184-M92.

Before attaching cylinders to a connection, be sure that the threads on the cylinder and the connection mate are of a type intended for the gas service.

When a compressed gas cylinder is empty, close the cylinder valve, and mark the cylinder as empty.

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Valves and Regulators

Compressed gas cylinders should only be used with a regulator that is specific for the gas/liquid in the cylinder.

NEVER tamper with, repair or alter cylinders, valves or safety pressure relief devices. (These devices are built in valves that allow a cylinder to be depressurized if the cylinder pressure increases to a dangerous level.)

Never lubricate valve outlets or connecting equipment. When oxygen under pressure comes into contact with petroleum based products there may be an explosive oxidation reaction.

Cylinder valve outlet connections must be American standard or CGA Pin indexed systems for high-pressure gases. Low pressure gas connections must be CGA diameter index.

Attaching a Regulator

1. Ensure that the cylinder is secured according to CSA guidelines on an approved cart or to wall by an approved strap or chain.

2. Verify the contents of the cylinder by checking the label and the cylinder color coding.

3. Remove the protective cap or wrap, and inspect the cylinder valve to ensure that it's free of dirt, debris, or damage.

4. Warn the persons present that the cylinder valve is about to be cracked. 5. Turn the cylinder valve away from any person present, and stand to the

side. Ensure that the valve outlet is not pointing toward any loose objects and then quickly open and close the valve.

6. Inspect the regulator for any evidence of damage, dirt or debris. All regulators shall comply with CAN/CSA-Z10524. Check label and confirm that it's intended for high-pressure use and for use with the gas that you have selected.

7. Using the proper wrench which is free of oil and grease. Attach the regulator to the cylinder outlet. NOTE: Never force the regulator/reducing valve on to cylinder.

8. Ensure that the regulator is in the off or closed position 9. Slowly open the cylinder valve and then close it. This will pressurize the

regulator. 10. After pressurization has occurred, watch the pressure gauge for a few

seconds to ensure that the indicator does not drop. This will verify that there are no leaks between the connection and the cylinder.

11. Slowly open the cylinder valve completely and turned back 1/4 turn. 12. When cylinder is placed in service ensure that the tag indicates in use.

Regulator Removal 1. Close the cylinder valve 2. De-pressurize the regulator by opening the flow control on the regulator

and allowing gas to flow from the unit. 3. Remove the regulator using either appropriate wrench for the American

standard safety system, or backing off the screw with the Pin index safety system.

4. If the cylinder is empty ensure that the label indicates empty 5. Place protective cap on cylinder if required.

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RADIATION SAFETY

CNA recognizes that the use of ionizing radiation devices for teaching purposes involves a risk to instructors, students and members of the public who might be in the vicinity. The use of ionizing radiation produces risks which can easily be overlooked by the uninformed. The school however is in the business of training individuals to competently work with ionizing radiation in professions where many benefits will result. Thus in terms of a risk versus benefit analysis the use of radiation emitting devices for the purpose of training is widespread and generally accepted. This does not mean that a careless attitude toward the use of radiation emitting devices is acceptable, it is not. The school recognizes that its use must only be to achieve clearly stated educational objectives and the ALARA (As Low as Reasonably Achievable) principle is strictly followed. Students in Medical Radiography will be provided a copy of the School of Health Sciences X-ray Safety Program as part of their orientation to the X-ray lab area.

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GLOSSARY

ABHR Alcohol Based Hand Rub

Aerosol A cloud of tiny droplets suspended in the air.

Aseptic A product or method that is free of microbiological organisms.

Autoclave An instrument for sterilization by means of moist heat under pressure

BSC Biological Safety Cabinet

Bloodborne

pathogens

Pathogenic microorganisms that are transmitted via human blood and cause disease in humans.

CCOHS Canadian Center for Occupational Health and Safety

CDC Center for Disease Control

CNA College of the North Atlantic

CO2 Carbon dioxide

CPR Cardiopulmonary Resuscitation

CSA Canadian Standards Association

Decontamination Procedures that remove contamination by killing microorganism, rending the items safe for disposal or use.

Disinfection Refers to the destruction of specific types of organisms but not all spores, usually by chemical means.

HEPA High Efficiency Particulate Air

IV Intravenous

MSDS Materials Safety Data Sheet

Microorganism Organisms studied with a microscope, includes viruses.

OHS Occupational Health and Safety

PPD Prince Phillip Drive Campus

PPE Personal Protective Equipment

PSDS Pathogen Safety Data Sheets

Pathogens Any organism capable of causing disease in its host.

Regulator A mechanical device through which the flow of a gas can be controlled.

SDS Safety Data Sheets

Segregation To separate for special treatment.

Sharps Any needles, scalpels or other article that could cause wounds or punctures to persons handling them.

Sterilization Complete destruction or removal of all microorganisms or physical means, use to provide sterile items for use.

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TDG Transportation of Dangerous Goods

UV Ultra Violet

WHMIS1988 Workplace Hazardous Material Information Systems 1988

WHMIS2015 Workplace Hazardous Material Information Systems 2015

WHSCC Worker Health Safety and Compensation Commission (Now Workplace NL)

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Appendix 2

School of Health Sciences Box 1693, St. John’s, NF A1C 5P7

STUDENT NEEDLESTICK/BIOLOGICAL EXPOSURE INCIDENT REPORT FORM

Page 1of 2

Last Name: ________________________ First Name: ________________________

Date of Birth: ______________________ Student #: _________________________

Home Address: __________________________________________________________

Home Phone:___________ Cell Number:__________ Program of Study: _______________

Date and Time of Injury/Exposure: ______________________________________________

Reported to Name (Preceptor/Supervisor): _____________ Date and Time: _____________

Reported to Program IC (Name): ______________________ Date and Time: ____________

Name of the Institute where incident occurred:____________________________________

Physical location where incident occurred (Radiology, patient room, ambulance etc): ____________________________________________________________________________ Nature of Accident/ Incident (describe how incident happened) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What (if any) First Aid or treatment was administered? _____________________________

Name of person who gave First Aid: _____________________________________________

Witness Name and Contact Information: _________________________________________

Were you the user of the sharp object? Yes___ No___ Not Applicable___

The sharp item was: Contaminated____ Uncontaminated____ Unknown____

Was the source identifiable? Yes___ No___ Unknown___ Not Applicable___

Was the source’s blood tested for HIV, Hepatitis A and B Titers? Yes___ No___

Was Post Needlestick Assessment Performed by: ______OHS Nurse ______ER Physician

Date and Time of Assessment:__________________________________________________

Did you have blood drawn for HIV, Hepatitis A and B Titers? Yes____ No____

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NEEDLESTICK/ BIOLOGICIAL EXPOSURE INCIDENT REPORT FORM

Page 2 of 2

Have you been previously vaccinated against Hepatitis B? Yes___ No____

Is your Anti Hbs Titre Protective? Yes____ No____ Unknown______

What Post Needlestick Counseling information did you receive during or immediately following the assessment? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Further to your immediate Post Needlestick Assessment, were you informed either verbally or in writing the status of the sources blood work? Yes____ No____

From whom did you receive this information? _____________________________________

Is this a Student Accident Citadel Insurance Claim? Yes____ No ____

Are you on a work term or Clinical Practicum? Yes____ No ____

If Yes complete this section

Did you inform the OHS Nurse or the Emergency Room Physician that you are covered by WHSCC while on a work placement? Yes_____ No______

Did you complete a WHSCC Form 6 (Workers Report Form)? Yes___ No___

Was a WHSCC Form 7 (Employers Report of Injury) completed and submitted? Yes__ No__ Was a WHSCC Form 8/10 (Doctor’s Report of Injury) completed and submitted? Yes___ No___

Student Name: First Aid Attendant: Reporting person:

Signature: Signature: Signature:

Date: Date: Date:

NOTE: Copies of this report to be sent to: BSG students – CA office (709)643-7827

GFW students- CA office (709)489-4180 PPD student s– Campus Nurse (709)758-7478