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in the Chemical laboratory Edited by NORMAN V. STEERE, 1 4 0 Melbourne Ave., S.E. Minneapolis, Minn. 5 5 4 1 4
LIII-Safety in the Clinical Laboratory* GRACE MARY EDERER, M.P.H.?, University of Minnesota College of Medical Sciences, Minneapolis and BARBARA TUCKER, M.T. (ASCP)$, Northwestern Hospital, Minneapolis
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departmental safety committees. All committee recommendations are passed through proper channels to insure administrative awareness, approval and financial Whenthisdelegstionofres~onsi(Continued on page A974)
Hospital administrators and laboratory supervisors are ultimately responsible for creating a safe enviranrnent, but staff members should also participate by serving on safety cammittees. Act,ive participation stimulates t,heir interest and concern about safet.y, and committee members in turn educate others. Dynamic safety programs provide another positive approach in teaching and motivating workers to follow safe procedures.
A chemist w54 disemboweled while opening a bottle of ether. The report' stated: "The st,opper appeared to be stuck tightly so he grasped the bottle in one hand, pressed it to his stomach and t,wisted the stouuer with his other band.
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man and tearing off several fingers. . . I t was concluded that, this accident was caused by peroxides which formed in the ether while it sat on the storage shelf." This true story cannot help but strike a dissonant chord in the most placid mind and should alert one to the need for safety knowledge. The combination of circumstances that led to such a grave and irrevocable accident could have been p r e vented. Specific information about safe handling of ether in general and peroxide formation in ether in particular is rtvailable in t,he "Handbook of Laboretory Safety."a The incident is cited to dramatiae the enormous need for careful planning to create a safe environment for laboratory personnel. Such planning will also protect the patients and the hospital physical plant. The responsibility for creating a safe environment and educating personnel in safety practices rests with the hospital's administrative staff. Often t,hsy delegate part of this responsibility to general and ~p
*Reprinted wit,h permission from Postgraduate Medicine 44, No. 3, Sep. 1968, p. 4 1 4 4 0 McGraw-Hill, Inc. t Associate Professor, Division of Medical Technology, Department of Labor* tory Medicine, University of Minnesota Cnlleee of Medical Sciences. Minneauolis. $ cxieief ~Medi&l ~echnolbgist,~ l i k e a l Laboratories, Northwestern Hospital, Minneapolis. ~
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hility is concurrent with a well-defined line of authority, safe conditions should prevail. Committee action involves many persons, who become informed about safet,y and who educate others as a. byprodnct of their interest and concern. This approach provides a t,wofold service: It expedites the correcbion of unsafe practices or conditions, and imprints safety principles 011 the minds of all employees in a posit,ive manner rabher than by a discipliusry "No.', When the focus is changed fmm broad asuects of all-hospital safety to laboratory saiety in particular, the firit question that should he answered is: Who is resnonsihle
section supervisor hears "line authority and responsibility" proportionate to his responsibility for the quality and quantity of service, and each person is responsible for his own safety and that of his fellow workers. Legislation recently enacted in Minnesota. recognizes this line of responsibility in stating that all pupils, teachers and visitors must wear eye-protective devices while participating in or observing activities in eye-protection areas (areas involving work which is potentially hazardous to the eye) of an educational institution. The law clearly states that any student who does not wear safety goggles in a teaching laboratory may be suspended. What would happen from a legal standpoint if s student sustained an eyeinjury while be was not wearing protective goggles? I f all persons responsible for laboratory safety had adequately carried out their responsibilities and the accident occurred because the student failed to follow the rule, all other persons would he
plinmians, set good examples of safety pracbicea, and he authoritrtt,ive leaders. I n order to teach ssfety and provide far continuing education in this field, the department should have a safety reference library that is available to all technical personnel a t d l times. The materials listed in "llqference Library Suggestions'' (see next page) have been helpful in preventipg nnsaie conditions end have provided guidance for procedures to be used in the event of an accident. When an accident occurs despite education and discipline, the person involved should report it in writing. The section supervisor, the chief technologist and t,he pathologist should review the report and take st,eps to prevent recurrence of the same t,ype of accident. Finally, the report should be referred to the general hospital safety committee or the hospital administrstion, or both. Each year accidents should he tabulated according to classification of employee involved, type of injury, part of body injured, and other pertinent categories. Evaluation of each year's accident rrtt,e and comparison with previous year's records will suggest ways to promote a more perfect safety record for the coming year.
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Is it necessary to have a laboratory safety committee? The answer is "Yes!" Part,icipation on such a. committee is another way to involve personnel snd stimulate them to learn mare about safety. The motivation of a committee member is greater because of the delegated respansibility that goes with membership. I t would be strategic to consider laboratory attendants and clerical staff as well as technical personnel for committee membership, since total laboratory participsr tion in safety awareness is important, To he effective the commit,tee must hsve duties to perform. One important task is regular inspection tours of the laborat or^.^ A written report of any unsafe findings should he referred to the lahoratory administration with recommendations for correction of the problem. Tho committee should make a return inspection after the condition has been corrected. Another committee a~signmentshould he the study of all accident reports in order to develop a safety program. Does the laboretory need a, safety program? Again the answer is "Yes." St&tistics dispute workers who believe aecidents will not occur and especially those who believe "It won't happen to me."' Fortunately, this type of overconfident worker is in the minority. When medical technologists were polled in lR66,5 707' favored further emphasis on lahoratory safety education. I n the same poll, 91% felt t,hat custodial and other nontechnical personnel were not sufficiently aware of potent,ial hazards in the laboratory. A safety program might he described hriefly as a dynamic educational endeavw to make each laboratory staff memher want t,o follow safety regulations without any defections.' Visual aids arch a- h d letin hoard posters, safety slogans, and films a n safety, if well chosen, can impart, a wealth of information with little consumer effort. Fire department,^, insurance agencies and the National Safety Council are resources of information on this subject. The key to success is to keep the program in motion. People soon lose interest in reading old posters. Is it necessary to hsve both a safely program and a. safety committee? Each laboratory must objectively answer this question. With active leadership from t,he pathologist and the chief t,echnologist, committee and program can he merged into t,otd laboratory participation without. defined titles. Safety by this method is an every-minnte affair rather than a monthly assignment. One last question might be asked: What will he the next step to i~!sure lahoratory safet,y in the future? If elinicxl technology from t,he chemical and instrument standpoint continues to develop a t the present rat,e, it will probably be necessary to have a safety engineer o n the lahorat,ory staff. Phasing into such x security program could be done economically by mult,ihospital sharing of a pel.son with this background. 111 summary, laborat,ory safety is x major responsibility of hospital and lab(Continued on page A976)
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oratory administrators and each staff member. Staff participation and the diffusion of knowledge can he accomplished through safety committees and programs. One might consider safety analogous to a child's hoop. I t moat he pushed to get it rolling, but once started it is relatively easy to keep it rolling with a regular hut gentle push.
REFERENCES 1. Case History No. 603: Case Histories of Accidents in the Chemical Industry. Val. 2. Washington, D. C. Msnufacturing Chemists' Assoeiation, Inc., 1966. 2. Handbook of Laboratory Safety. Cleveland, Chemical Rubber Company, 1967. 3. ANDERSON,E. C . : Why have lahoratory safety inspections? Mznn. Chen. 20, 18 (February) 1968. 4. EDERER, G. M. and TUCKER,B.: Accident surveys and safety programs in two hospital clinical laboratories. Arner. J. Med. Techn. 26, 219, 1960. 5. ALLEN, J. E.: XXIX. An exploratory study of the attitudes of laboratory workers toward accident prevention. THIS J O U R N - k ~ ,43, A861 (October) 1966. 6. TUCKER,B.: Safety program in the hospital. Safety Newsletter, National Sajkly Council, August, 196.5. REFERENCE LIBRARY SUGGESTIONS 1. Handbook of Oreanic Industrid Sol.
bepartment, National Fire Protection Association. 60 Battervmereh Street, Boston 02110. Manual of Hazardous Chemical Kenctions." NFPA No. 4 9 1 M
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3. Journal of Chemicnl Education and Safety in the Chemieal L:tborntory. Edited by Norman V. Steere. School of l'ublie Henlth. Univenits of
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Michigan 48640. 6. A Condensed Lnborntory. Hnndhobk, E. 1. d u I'ont de Nemoum & Co. (Inr,.). Wilminaton, De!nwnre 19898.
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