Clinical Laboratories - HSE

1 Page 1 of 69 Health and Safety ExecutiveSafe working and the prevention of infection in Clinical Laboratories and similar facilitiesThis book provides health and safety guidance for managers, health and safety officers and employees in Clinical pathology Laboratories . The guidance is relevant to the collection and handling of diagnostic specimens in patient care areas as well as the laboratory. The book will help you to identify and assess the risks of infection and take appropriate precautions to control such risks. It also focuses on preparing standard operating procedures and ensuring that everyone is aware of the risks and how to manage BooksPage 2 of 69 Health and Safety Executive Crown copyright 2003 First published 1991 ISBN 978 0 7176 2513 0 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the copyright for reproduction should be made in writing to: The Office of Public Sector Information, Information Policy Team, Kew, Richmond, Surrey TW9 4DU or e-mail: guidance is issued by the Health and Safety Executive.

2 Following the guidance is not compulsory and you are free to take other action. But if you do follow the guidance you will normally be doing enough to comply with the law. Health and safety inspectors seek to secure compliance with the law and may refer to this guidance as illustrating good working and the prevention of infection in Clinical Laboratories and similar facilities Page 3 of 69 Health and Safety ExecutiveContentsIntroduction 6 Health and Safety Law 7 Health and Safety at Work etc Act 1974 7 management of Health and Safety at Work Regulations 1999 7 Control of Substances Hazardous to Health Regulations 2002 8 Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 8 Consulting employees 9 Duties to non-employees 9 Lone workers 10 Health and Safety management 10 Roles and responsibilities 10 Supervision 10 Laboratory safety officers 11 Health and safety arrangements 11 Risk assessment 12 Categorisation of biological agents 13 Containment levels 14 Buildings and accommodation 16 Security and access 17 Heating, lighting and ventilation 17 Fittings and furniture 17 Floors 18 Staff welfare facilities 18 Standard operating procedures and safe working practices 18 Standard operating procedures 18 Provision and use of personal protective equipment (PPE)

3 19 Personal hygiene 20 Risks and prevention of blood-borne infections 21 Handling specimens and biological agents 22 Stock cultures 22 Ampoules 23 Media preparation 23 Plating out 23 Handling unfixed specimens for slide preparation 24 Electron microscopy 24 Sharps 25 Action after sharps injury or contamination with blood or other body fluids 25 Equipment 26 Automated laboratory equipment 26 Non-infection risks associated with equipment 26 Homogenisers and shakers 27 Cryostats 27 Centrifuges 27 Microbiological safety cabinets 29 Laboratory autoclaves 31 Review and revise practices and procedures 34 Safe working and the prevention of infection in Clinical Laboratories and similar facilities Page 4 of 69 Health and Safety ExecutiveLabelling, transport and reception of specimens 35 Information 35 Transport 35 Reception of specimens at the laboratory 37 Cleaning, decontamination and waste disposal 38 Cleaning and decontamination 38 Disposal of laboratory waste 39 Packaging sharps 40 Information, instruction and training 40 Staff training 40 Health surveillance and immunisation 41 Before employment 41On employment.

4 Immunisation 42 During employment 42 Medical contact cards 43 Incidents and accidents 43 Dealing with incidents and accidents 43 Dealing with spillages 44 Fires 45 Measuring, auditing and reviewing performance 46 Measuring performance 46 Audit of performance 46 Review of performance 47 Appendix 1 Microbiological safety cabinets 47 Appendix 2 Disinfectants and disinfection in the Clinical laboratory 52 Appendix 3 Packaging requirements for some diagnostic specimens 56 Appendix 4 Staff safety guidelines 57 References 65 Further information 69 Safe working and the prevention of infection in Clinical Laboratories and similar facilities Page 5 of 69 Health and Safety ExecutiveOrganisations represented on the Health Services Advisory Committee.. Working Group MembersMs M Burrows Northampton Commissioning Primary Care Group (formerly, Oxford Radcliffe NHS Trust)

5 Dr AC McCartney Central Public Health Laboratory, Colindale Mr S Philip St Mary s NHS Trust, Paddington Mr J Richards UNISON Health CareDr T Wyatt Mater Hospital NHS Trust, Belfast Mr K Ashley Health and Safety ExecutiveMr D Head Health and Safety ExecutiveMs J Lopex Health and Safety ExecutiveMs S Williams Health and Safety ExecutiveConsultees Advisory Committee on Dangerous PathogensAIDS Education and Research TrustAssociation of British Health Care IndustriesAssociation of Clinical BiochemistsAssociation of Clinical PathologistsAssociation of Medical Research CharitiesAssociation of Medical MicrobiologistsBiotech Group, Chemical Industries AssociationBiotechnology and Biological Sciences Research CouncilBritish Occupational Hygiene SocietyBritish Society for HaematologyBritish veterinary AssociationClinical Pathology Accreditation (UK)

6 LtdConfederation of British IndustryDepartment of HealthGlaxo WellcomeHealth Services Advisory CommitteeHospital Infection SocietyInfection Control Nurses AssociationInstitute of Biomedical ScienceInstitution of Occupational Safety and Health London School of Hygiene and Tropical MedicineMedical Devices AgencyMedical Research CouncilManufacturing Science FinanceNational Assembly for Wales - Public Health DivisionNational Institute for Biological Standards and ControlNational Institute for Medical ResearchNHS EstatesPathological Society of Great Britain and IrelandPublic Health Laboratory ServiceRoyal Society for the Prevention of AccidentsRoyal College of PathologistsRoyal College of veterinary SurgeonsRoyal Institute of Public Health and HygieneScottish Executive Scottish Health Care SuppliesUniversity of BristolWillis Scotland Ltd Safe working and the prevention of infection in Clinical Laboratories and similar facilities Page 6 of 69 Health and Safety ExecutiveIntroduction1 This book provides guidance on health and safety for all those involved in work in Clinical pathology Laboratories .

7 It updates and replaces the Health Services Advisory Committee (HSAC) publications Safe working and the prevention of infection in Clinical Laboratories and The guidelines for staff and visitors, both published in 1991. This document develops the content of the two earlier books by setting the guidance in the context of the requirements of the management of Health and Safety at Work Regulations 1 and the Control of Substances Hazardous to Health The guidance is relevant to work in hospitals and other facilities where people may be exposed to biological agents, for example in universities, research establishments, primary care facilities and veterinary Laboratories . It applies to diagnostic work in patient care areas, such as outpatients departments, intensive therapy or neonatal units and to work by general practitioners at their Advice is given for all parties involved in the management and operation of Clinical Laboratories : employers and senior managers who have responsibility for setting policies and for ensuring that risks are assessed and eliminated or controlled; line managers, such as laboratory managers, who may be responsible for implementing policies and procedures; employees who work in Clinical Laboratories .

8 And others who can influence policies and good practice, such as laboratory safety managers, risk managers, health and safety officers, and employee safety This guidance is intended to help these parties: identify and assess the risks of infection; take appropriate precautions to eliminate or control such risks; prepare standard operating procedures, setting out the precautions and arrangements for carrying out the work; ensure that everyone is aware of the risks and what to do about them; meet their duties under health and safety The guidance emphasises the need for employers and employees to work together to create an environment and culture in which safe practices and appropriate work procedures and policies are prepared, adopted, and A separate HSAC publication deals with safe working and the prevention of infection in the post-mortem room and 7 The Advisory Committee on Dangerous Pathogens (ACDP)

9 Has also published guidance, The management , design and operation of microbiological containment Laboratories ,4 which expands on the legal requirements set out in the Control of Substances Hazardous to Health Regulations 2002,2 with a focus on the design, construction and operation of Laboratories which are used for containment of microbiological work at containment levels 2 and 3. 8 The terms should and must are used throughout this document to convey obligation. They are of equivalent meaning, and are used where the guidance offers a way of complying with a legal duty, as distinct from recommendations on what constitutes good working and the prevention of infection in Clinical Laboratories and similar facilities Page 7 of 69 Health and Safety ExecutiveHealth and safety lawHealth and Safety at Work etc Act 19749 The Health and Safety at Work Act 5 places general duties on employers, employees and others.

10 Health and Safety at Work Act - key dutiesEmployers must: protect the health and safety of their employees; protect the health and safety of others who might be affected by the way they go about their work (for example, cleaners, visitors or contractors working in the laboratory); prepare a statement of safety policy and the organisation and arrangements for carrying it out (if 5 or more people are employed, this statement must be written down).Employees must: take care of their own health and safety and that of others; co-operate with their only the courts can give an authoritative interpretation of the law, in considering the application of the Act and its regulations and guidance to people working under another s direction, the following should be considered: if people working under the control and direction of others are treated as self-employed for tax and national insurance purposes they are nevertheless treated as their employees for health and safety purposes.