Archive for: Bloodborne Pathogens
We hear it every day like a broken record – wear your PPE and know what you are doing when you are working with hazardous chemicals in the workplace. Unfortunately, too many people don’t listen and they end up paying the ultimate price.
I’m reminded of this today as I read more about the janitor in an elementary school in Plymouth, Massachusetts who was apparently overcome and died from exposure from an as-yet unknown chemical on Monday morning.
If you’re just learning about this, 53-year-old Chester Flattery, the head custodian at Manomet Elementary School, was found dead by the school secretary at about 8 a.m. That employee and 12 other people – many of them police officers, firefighters and other first responders who were exposed – had to also be taken to the hospital for treatment.
The investigation is still ongoing, but reports say Flattery had been at work for an hour before anyone else and that he may have been applying a floor sealant at the time of his death. School is not in session and there is a lot of maintenance work that goes into getting the building ready for next year.
Now, we all in workplace safety world know he was supposed to be wearing a respirator, eye protection, and other protective equipment. I have been a teacher in an elementary school, and I have seen these guys hard at work getting the school ready, even as I was getting my own classroom ready for students.
Most of the time, they are in regular street clothes as they go about their duties and I am willing to bet Flattery was no exception. As someone who had been working there since 2007, he was probably just doing what he always did – this time the fumes were too much for him and no one was there to help him until it was too late.
It almost happened to me. Back in college, I worked as a pool director at a country club in Connecticut, responsible for maintaining the proper chemical levels. One morning, I went into the supply closet looking for chlorine pellets, not knowing that one of my lifeguards hadn’t tightened the cover of the bucket properly the night before, allowing rain water to seep in. When I took the cover off, I got hit with a cloud of chlorine gas that knocked me off my feet and burned my throat. Happily, I was able to get to fresh air quickly and was fine. But no one was around and I was not wearing any kind of protection. I was lucky, and I never made the same mistake twice.
In the healthcare field, you can take a lesson from this tragedy. Don’t assume that just because you have done a job for a long time, you can ignore the rules. OSHA has bloodborne pathogens and hazardous chemical standards for a reason. If you are working with patients, wear your gloves, use your safety sharps, and lift safely.
If you are in a lab and work with chemicals, make sure you know the hazards of what you are working with and how to handle it properly, as well as any first aid information – it’s why OSHA says you must have SDS safety sheets on site. And always be sure someone is around, because it may save your life.
The following is an occasional series of guest blogs by experts in the medical clinic safety field. If you would like to be featured in this blog as a guest columnist, please email Managing Editor of Safety John Palmer at firstname.lastname@example.org.
In some laboratories, the use of Personal Protective Equipment (PPE) may be confusing to staff. However, a look at OSHA’s Bloodborne Pathogens and Chemical Hygiene Standards should make clear the requirements for proper PPE selection and use.
Both standards speak clearly to the necessity of PPE when working in the laboratory. Different PPE is needed for different tasks. Lab coats are always necessary in the lab for protection against blood and body fluid splashes or chemical splashes. Plastic aprons may also be used as extra protection in areas where gross tissue work is performed. Lab coats should be buttoned, the sleeves should not be rolled up, and they should be knee-length.
Gloves are needed when handling blood, body fluids, or chemicals, but different gloves may be used for different tasks. Many labs are turning away from using latex gloves because of allergic reactions by staff. Nitrile gloves have become the norm in recent years. However, make sure you have the correct gloves for the duties being performed. Some manufacturers make nitrile gloves that act as a barrier against blood and body fluids, but they do not provide protection against chemicals. While these will be fine while running a CBC in hematology, they won’t provide enough protection when changing the stainer. Be sure to use chemical-resistant gloves for this and other tasks (gram stains, handling chemistry reagents, pouring acids, etc.). Check the package if you are not sure about the proper use of gloves.
Goggles or face protection is important PPE that is widely under-utilized. Do you carry open specimens in the lab? What about carrying a rack of specimen tubes to or from an analyzer? That is a task that creates a risk for exposure, and face protection should be used. Are you pouring a chemical? Protection is necessary. Help your staff avoid all exposures to the eyes or mucous membranes.
The OSHA standards mentioned above also require that PPE is removed before leaving the laboratory. Do not wear lab coats or gloves to another location outside the laboratory. Does a procedure need to be performed in another area that requires PPE? If so, bring fresh PPE with you for use in the treatment area and dispose of it before returning to the lab.
In a laboratory, all areas should be considered hazardous, bio-hazardous, or contaminated. Do you have a desk area in the lab where only paperwork is done? I have always said that if there is an area in the lab where there are no patient specimens or chemicals, then one could consider the area “clean.” However, that does not mean that food or drink can be consumed there or that no PPE is needed. Remember, you are still in the walls of a laboratory, and accidents may occur. It is acceptable to label the area as “clean” so that gloves are not needed for the computer or phone, but a lab coat would still be required.
Remember, if an OSHA inspector arrives, he will be looking to see that all aspects of safety regulations are being followed. Keep your employees safe and keep your facility from unnecessary fines by using PPE where and whenever needed.
Dan Scungio, MT (ASCP), SLS, also known as “Dan the Lab Safety Man,” is a Laboratory Safety Officer for Sentara Healthcare, a multi-hospital system in the Tidewater region of Virginia.
An investigation by the Colorado Department of Public Health and Environment indicates that as many as 8,000 dental patients may have been exposed to bloodborne pathogens from unsafe injection practices.
The CDC updated the guidelines for how facilities should manage healthcare providers with hepatitis B so as to reduce the risk of transmitting the virus to patients.
The Advisory Committee on Immunization Practices (ACIP) recommends that healthcare workers “with reasonably anticipated risk for exposures to blood or infectious body fluids receive the complete Hepatitis B vaccine series and have their immunity documented through postvaccination testing.” OSHA Healthcare Advisor asked its readers what percentage of their workers met ACIP recommendations? Here are the results:
Q: If an employee agrees to the hepatitis B the vaccination but fails to follow through on the titer one to two months after the series, what should I do for OSHA compliance?
To put it bluntly, the FDA, CDC, NIOSH, and OSHA want to see more use of blunt-tip suture needles in operating rooms.
The four federal agencies posted a joint announcement on May 30 reminding “health care professionals to use blunt-tip suture needles as an alternative to standard suture needles when suturing fascia and muscle to decrease the risk of needlestick injury.”
More than 10 years after the passage of the Needlestick Prevention and Safety Act phlebotomy procedures still pose significant needlestick risks for healthcare workers. A free webinar for nursing staff will discuss “the most recent needlestick injury data and nurses’ rights under current laws/regulations, as well as provide a review of available safety-engineered technologies and the benefits and limitations of each class of devices.”
May is Hepatitis Awareness Month and May 19 was designated as National Hepatitis Testing Day in the United States. The CDC has identified protecting patients and workers from healthcare–associated viral hepatitis as one element in its comprehensive viral hepatitis action plan. In protecting healthcare workers from Hepatitis B, the Advisory Committee on Immunization Practices (ACIP) recommends that healthcare workers “with reasonably anticipated risk for exposures to blood or infectious body fluids receive the complete Hepatitis B vaccine series and have their immunity documented through postvaccination testing.”
Of the workers in your healthcare facility with reasonably anticipated risk for exposures to blood or infectious body fluids, what percentage do you estimate meet the ACIP recommendations for Hepatitis B vaccination and postvaccination testing? Take the OSHA Healthcare Advisor Weekly Poll and let us know.
Q: My practice rents space to another practice with employees. They use none of our supplies and operate as a separate business. Is my practice responsible for OSHA training for their employees?
Fewer than half of dental school students showed “adequate knowledge of transmission and management” of occupational exposure to bloodborne pathogens according to a study appearing in the April issue of the Journal of Dental Education.
Safe in Common, a non-profit organization established to raise awareness about needlestrick hazards for U.S. healthcare personnel, has launched The Needlestick Safety Awareness Tour.