Hazard and Risk. Hazard is the potential to cause harm. Risk is the likelihood of that harm being realised

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1 WHAT IS SAFETY? Absence or minimisation of risk Occupational safety is not the absence of accidents, but the result of taking positive action to identify accident causes and implement and maintain suitable preventive measures

2 Hazard and Risk Hazard is the potential to cause harm Risk is the likelihood of that harm being realised

3 Health and Safety at Work Act 1974 Management Regulations 1999 Assessment Policy/Organisation YPs New and Expectant Mothers Specific Regulations Manual Handling VDUs PPE Work Equipment Workplace COSHH Pressure systems GMOs Ionising Radiation Noise etc.

4 Management of Health and Safety at Work Regulations Require employers to assess risks to workers and any others that may be affected by their work or business. Risk assessment is carried out to identify risks to health and safety to any person, arising out of, or in connection with, work. Risk assessment should be suitable and sufficient. Level of detail should be proportionate to the risk. Assessments should identify how long they will remain valid. Significant findings should be recorded. Assessments should be reviewed, and, if necessary, modified.

5 Identify hazards Risk assessment Identify who might be harmed, and how Evaluate risk Prevention Avoid risk altogether! Carry out risk assessment if risk cannot be avoided Combat risk at source, rather than using palliative measures Adapt work to the individual Use technological solutions Give priority to measures that protect the whole workplace Have coherent policy and approach; Positive h&s culture

6 COSHH Regulations Risk assessment in advance Eliminate risk or introduce controls to reduce risk to acceptable level Provide instruction, training and supervision Keep appropriate records - equipment testing, health surveillance etc

7 COSHH Requirements Assessment of health risks PREVENTION or control of exposure Maintenance of controls Monitoring Information, instruction and training Health surveillance Emergency plans

8 Hazardous Agents Toxic Corrosive Biohazard Ionising radiation / Radioactive Non-ionising radiation Laser Flammable Oxidising Explosive

9 Health Hazards and Effects TOXIC HARMFUL ILL HEALTH, CANCER GENETIC DAMAGE BIRTH DEFECTS CORROSIVE IRRITANT BURNS INFLAMMATION SENSITIZATION

10 Labelling Classification A substance which if it is inhaled, ingested or it penetrates the skin, may involve.. VERY TOXIC.extremely serious acute or chronic health risks and even death TOXIC.serious acute or chronic health risks and even death HARMFUL.limited health risks. F

11 Reactive Hazards and Effects HIGHLY FLAMMABLE OXIDISING FIRE EXPLOSION EXPLOSIVE

12 Biological agents and hazards Micro-organisms - infection, allergy, toxic, carcinogenic hazard Animals and products - allergy, zoonoses, bites/scratches Plant Materials - allergy, toxic, irritant GMOs - enhancement of all of these characteristics

13 ACDP Hazard Groups Group 1 Group 2 Group 3 Group 4 unlikely to to cause human disease can can cause human disease and and may may be be a hazard to to employees; unlikely to to spread in in community prophylaxis/treatment available can can cause severe human disease may may be be serious hazard to to employees; may may spread in in community usually prophylaxis/treatment can can cause severe human disease and and serious hazard to to employees; likely to to spread in in community no no effective prophylaxis/treatment

14 SOURCES of EXPOSURE Contaminated equipment, clothing, person Poor Practice & Accidents Atmospheric Pollution by fumes, gases, vapours, dusts Mixing of incompatibles: e.g. cyanides and acids F

15 Passive transfer via an inanimate object Direct contact with source Source of infection Airborne in dusts and aerosols Active transfer by animal vector (fleas, ticks, flies)

16 Routes of Entry into Body Inhalation Ingestion Skin contact Average lung surface area m 2 Average skin surface area 1.8m 2

17 Inhaled Dust Particles < 0.5µm remain in suspension Particles > 7 µm filtered out Particles 7-2 µm settle out Particles < 2 µm penetrate alveoli

18 Routes of exposure Inhalation Ingestion Skin contact Injection or wound

19 Routes of Infection Inhalation Ingestion Injection Cut/Abrasion Eye splash Brucella Mycobacterium Salmonellae Campylobacter E.Coli Hepatitis HIV HIVStaph. aureus Hep Hep HIV HIV Leptospira Staph. Strep. Meningococcus Lepto. Toxoplasmosis

20 Risk Assessment Identification of hazards What are you handling? What are the potential consequences? How might you be exposed? Who else might be exposed How likely is exposure? What controls are necessary?

21 Controlling risk Eliminate - do you have to do/use it? Substitute - is there a safer alternative? Enclose - enclosed process/ventilated enclosure Segregate - keep work away from others Procedures - safe technique, limit exposure time Train/supervise - ensure competence Information - use of signs etc PPE - personal protective equipment

22 Primary protection - How you do it Safe working practice Physical containment Spillage procedures Disinfection regime Autoclave waste

23 Secondary Protection Because your technique isn t t perfect Personal Hygiene Use of Personal Protective Equipment Immunisation

24 Tertiary Protection To protect them out there Lab design and layout Security and location Safe disposal of waste Control of visitors/contractors

25 Basics of laboratory containment Washable, non-absorbent surfaces Doors kept closed Hand wash sink Inward airflow where ventilation is mechanical Routine disinfection Minimise or control aerosols Safe waste disposal

26 Work at higher containment levels For Containment level 3 Lab must be sealable for fumigation Restricted access Doors must have viewing panel Exhaust air must be HEPA filtered Gloves must be worn Lab must be self contained with its own equipment as far as possible Use of SOPs

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28 Work with human material Must be carried out a a minimum of containment level 2 Level of containment may need to be changed if there is a suspicion that hazard group 3 agents may be present Work with blood borne viruses is permitted at containment level 2+ BUT ONLY IF THERE IS NO CONCENTRATION OR PROPAGATION OF THE VIRUS

29 Human Blood/Body fluid/tissues Risks from Hepatitis B virus, Hepatitis C virus and others - contact or needlestick HIV - contact/needlestick Tuberculosis - in sputum samples - airborne Transmissible spongiform encephalopathies - in neural and lymph material?

30 Hazards of Cell Culture From the Cells: Few hazards unless exposed to own cells transformed or or genetically modified --malignancy or or expression of of unusually active protein Biologically active cell products From any passengers : Adventitious agents e.g. viruses Contamination Components of culture medium Biologically active cell products

31 Safe Working Keep work area clean and free from clutter Arrange equipment carefully Avoid creating aerosols Do not stack culture plates too high Use plastic disposables where possible Keep biohazards in containers and open as little as possible Label all biohazards Clear up promptly at the end of an experiment

32 Safe working in cabinets Check it is working properly Minimise items in cabinet Load equipment before starting work Work towards back for best protection No centrifuges or bunsens Leave it running to clear after use

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34 Pipettes - should be inserted into fillers carefully Hypodermics and needles - Avoid use where practicable. NEVER resheath needles Other sharps, e.g. scissors, scalpels - Handle with care. NEVER arrest the fall of a sharp Other equipment

35 Puncture w ound Splash: - in eyes, mouth, or other mucous membranes - onto broken skin Encourage wound to bleed, wash w ith soap and warm w ater; Wash splashes thoroughly w ith warm w ater Report IMMEDIATELY to Occupational Health staff in Health and Safety Unit - Ext for further advice If Occupational Health are unavailable or if incident occurs out of hours report IMMEDIATELY to: Accident and Emergency Dept, Selly Oak Hospital Inform Safety Officer and send Accident Report to Health and Safety Unit Inform Occupational Health staff in University Health and Safety Unit at the earliest opportunity - Ext

36 Other equipment cont. Water baths - may become contaminated and should be cleaned regularly Centrifuges - Should be loaded carefully; Maximum speeds should not be exceeded; Aerosols may result from broken tubes

37 Protective Clothing Must be adequate, worn properly and kept in good condition Lab coats - should be decontaminated and cleaned regularly Gloves - Use the correct glove material for the work Latex allergy

38 Causes of glove allergies Type IV reaction - Can be caused by chemical additives in the gloves used to accelerate the vulcanisation process. Residual accelerators may be absorbed by the skin. Immune response occurs - an itchy rash appears after 6/8 hours. Type I reaction - Caused by latex proteins. Immune response follows resulting in release of histamine etc. Symptoms are immediate and may be localised, e.g. skin reaction, or systemic, such as wheezing/coughing. Occasionally anaphalaxis may follow.

39 Wear gloves only when necessary Practical strategy Stop using powdered gloves Use only low allergen or non latex gloves Seek advice immediately if you are concerned

40 Storage of biohazardous substances Labelled, leakproof containers Do not overfill fridge/freezer Store in vapour phase of liquid nitrogen Thaw before autoclaving Protect whilst thawing

41 Transport Local transport - use secondary containment Carriage of Dangerous Goods Regulations cover movement of infectious and diagnostic substances by road and rail ICAO technical instructions for air transport

42 Four stages of safe transport of infectious materials Classification Packaging Labelling Transporting

43 Sterilisation and disposal All potentially hazardous materials must be disposed of safely This usually entails autoclaving before disposal by incineration (although chemical treatment may suffice in some cases) Autoclaving should be carried out by trained personnel Usual cycle is 121ºC for 15 minutes Performance of autoclaves should be monitored

44 Chemical Disinfectants - caveats Variable activity Organic overload and other inactivations Correct dilutions in-use Shelf life Toxicity/Allergenicity

45 Disinfectants Hypochlorites - sporicidal, virucidal, fungicidal and bactericidal. Corrosive to metal surfaces. Inactivated by organic matter; Alcohols - Active against bacteria including mycobacteria. Do not kill all viruses or bacterial spores. Surfaces must be clean. Flammable; Phenolics - Good for bacteria and mycobacteria. Do not kill all viruses or bacterial spores; Aldehydes - sporicidal, virucidal, fungicidal and bactericidal. Problems with toxicity and sensitisation; Peroxygen e.g. Virkon - Claimed to be sporicidal, virucidal, fungicidal and bactericidal

46 Disinfectants - other things to remember Avoid mixing disinfectants - e.g. mixing hypochlorites and formaldehyde can give rise to bis-chlormethylether, a carcinogen; Hypochlorites should not be mixed with other detergents or acid as this will give rise to chlorine gas; Allow sufficient contact time; Obtain data sheets etc from manufacturer and ask for validation data; Carry out your own validation checks where possible AUTOCLAVE!!!

47 Clinical waste is... Wholly or partly human, animal tissue or blood or other body fluids, excretions, drugs swabs/dressings, syringes, needles being waste which unless rendered safe may prove hazardous to any person coming into contact with it. Any other waste from medical, nursing, veterinary, pharmaceutical teaching or research, blood transfusion, being waste which may cause infection to any person coming into contact with it.

48 Health surveillance and immunisation Where appropriate health monitoring will be provided Persons working with Hazard Group 3 pathogens will be kept on register Immunisation should never be regarded as the primary defence against infection, but may provide protection Hepatitis A (sewage work); Hepatitis B (human materials); Tetanus (animal work?)

49 Accidents and Emergencies Skin splash - wash with soap and water. Remove contaminated clothing Eye splash - irrigate thoroughly with water Mouth contamination - Rinse thoroughly with water Cuts, bites, abrasions etc - encourage bleeding, irrigate with warm water, clean wound SEEK MEDICAL ATTENTION IF RISK OF INFECTION