BIOSAFETY IN BTS. Learning Objectives Identify Biosafety Issues in the BTS work areas List the key...
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Transcript of BIOSAFETY IN BTS. Learning Objectives Identify Biosafety Issues in the BTS work areas List the key...
Learning Objectives
• Identify Biosafety Issues in the BTS work areas • List the key requirements for the safe disposal
of biological and chemical waste
Definition
• The use of lab practices and procedures and equipments for safety when working with potentially infectious microorganisms.
Why Biosafety Practices?
Protection of-• Workers • Products• Co workers • Lab support personnel • Environment• Regulatory requirements
Risk of occupational transmission of infection depends on
• Prevalence of infected individuals in the population
• The frequency of exposure to contaminated medical instruments
• The relative infectivity and concentration of the virus
• If there is an exposure to a large quantity of blood
Risk of occupational transmission of infection depends on ( Contd..)
• Deep needle stick injury
• Injury with hollow bore needles
• Patient samples positive for TTIS
Infectious risk to HCWs From Percutaneous Exposure
Rule of 3’ HIV - 0.05 to 0.3% HCV - 3.0 to 10% HBV - 10 to 30%
Others atOthers at RiskRiskMunicipal workers Ragpickers Community
Viral Load in CirculationViral Load in Circulation
• HIV – 10 to 100 viral particles/ml
• HCV- 10,000 to 100,000 viral particles/ml
• HBV- 10,000,000 viral particles/ml
Modes of Exposure to Blood Pathogens in the Laboratory
Lab procedure
HCW at risk Source of transmission
Collection of blood/body fluids
Doctors/Laboratory technician/Nursing staff
Needle stick injury, broken specimen container, blood contamination of hand with skin lesion/breach
Transfer of specimen /blood unit
Laboratory technician and transport worker
Contaminated exterior of the container/ requisition slip
Processing of specimen /blood unit
Laboratory personnel
Puncture of skin or contamination of skin/mucous membrane from Contaminated work surface Spill/splash of specimen container Faulty techniques
Lab procedure
HCW at risk Source of transmission
Cleaning /washing
Support staff Puncture/contamination of skin from Contaminated glassware Sharps Contaminated work surface
Disposal of waste
Laboratory personnel support staff
Contact with infectious waste specially sharps
Transport to distant laboratory/hospital
Transport/postal staff
Broken/leaking container
Modes of Exposure to Blood Pathogens in the Modes of Exposure to Blood Pathogens in the Laboratory, contdLaboratory, contd
Interruption of TransmissionInterruption of Transmission
• Barriers
• Disinfection
• Vaccination
• Post exposure prophylaxis
• Safe biohazardous waste disposal
Good Lab Practices Good Lab Practices
• General rule - all samples be treated as potentially infectious
• Universal precautions are to be consistently used by all HCW
Universal precautions are those consistently used by all HCW
General Lab HygieneGeneral Lab Hygiene
• Cleaning of work surfaces and equipment with suitable disinfectant
• Restricted entry to work areas. • Avoid eating, drinking in the labs. • Avoid mouth pipetting.• Use laminar air flow hoods where necessary.
Universal Precautions• BARRIER PROTECTION
• HAND WASHING
• SAFE TECHNIQUES
• SAFE HANDLING OF SHARP ITEMS
• SAFE HANDLING OF SPECIMEN (blood etc.)
UNIVERSAL PRECAUTIONS (contd.)
• SAFE HANDLING OF SPILLS OF BLOOD/BODY FLUID
• USE OF DISPOSABLE/ STERILE ITEMS• SAFE TECHNIQUES -MECHANICAL PIPETTING
DEVICE • IMMUNISATION WITH HEPATITIS B VACCINE
Gloves
• Wear well fitting disposable vinyl gloves
• Change gloves if torn or visibly contaminated with blood
• remove gloves before handling door knobs, telephones, pens, leaving the lab
Laboratory gowns • Should be worn when in the lab. and should be
removed before leaving.• Use plastic aprons while cleaning re-usables and
disposing waste.
Facial protection • Cheap deflector masks or protective glasses
should be used if splashing of sample is expected.
Occlusive bandage• Cover all cuts and breaks with wash proof
bandage before patient care.
HAND WASHING
• WASH THROUGHLY WITH WATER AND SOAP IMMEDIATELY - AFTER CONTAMINATION WITH BLOOD/BODY FLUIDS.
• AFTER REMOVING GOWN/GLOVES.• BEFORE EATING, DRINKING & LEAVING THE LAB.• LABS SHOULD BE PROVIDED WITH LIQUID SOAP DISPENSERS.• USE MOISTURISING HAND CREAM AFTER EVERY HAND WASH.
GLOVES ARE NOT A SUBSITUTE FOR HAND WASHING
Safe Handling Techniques in Lab• Centrifuge tubes with safety caps should be usedSHARPS: • Do not bend/ break/ recap/ manipulate or remove needles
from disposable syringe.• Extreme care should be taken to avoid auto-innoculation.• Chipped/broken glassware should be disposed off in
appropriate containers.• Don’t use hands to pick up broken glass.
SAFE HANDLING OF SPECIMEN
• Collect samples in sterile screw cap plastic containers.• Seal properly to prevent spill/leakage.• Use sterile disposable syringes and needles/vacutainers.
Cover cuts with waterproof bandages.• Transfer leaked samples to fresh container, rewrite patient
information on the new container.• Reject requisition slip contaminated with blood or handle
using gloves in case of emergency.
Safe Handling of SpillsIN CASE OF BLOOD SPILLS
• COVER THE AREA WITH PAPER TOWELS OR GAUZE SPONGES TO ABSORB THE LIQUID.
• Cover the spill AREA WITH DISINFECTANT SOLUTION . (0.5-1 % Sodium Hypochlorite –freshly prepared). - LEAVE IT FOR 30 MIN - With 4% hypochlorite solution leave for 10 minutes.• WASH THE AREA THROUGHLY WITH SOAP AND WATER.• CONTAMINATED MATERIAL TO BE DISPOSED OFF AS INFECTIOUS
WASTE.
Prompt Accident ManagementPrompt Accident Management
• Spillage • Rupture of blood bag in the centrifuge,
breakage of tubes. • Leakage of blood bag in transport containers. • Needle stick injury; blood splashes
Biomedical Waste
• Biomedical Waste means any waste, which is generated during diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals and including categories mentioned in Schedule I
Biomedical Waste Management• Improper disposal / treatment of un-segregated
and segregated medical waste is a potential hazard affecting the health of the patients, health care workers, the community as well as the environment.
• A notification regarding Biomedical Waste (Management & Handling) Rules,1998 has been published by the Ministry of Environment & Forests.
Safe Disposal
• Segregation • Disinfection • Storage • Disposal
Biomedical Waste (management and handling ) Rules, 1998Ministry of Environment and Forests. GOIAmendment of the Rules is under process
Categories of Bio-Medical Waste
Option Waste category Treatment & disposal
Category 1 Human anatomical waste Incineration/deep burial
Category 2 Animal anatomical waste Incineration/deep burial
Category 3 Microbiology & Biotechnology waste
Local autoclaving/microwaving/ Incineration
Category 4 Waste sharps Disinfection (/autoclaving/ microwaving and mutilation/shredding
Category 5 Discarded Medicines and Cytotoxic drugs
Incineration/destruction and drugs disposal in secured landfills
Category 6 Solid waste (items contaminated with blood and body fluids)
Incineration autoclaving/microwaving
Categories of Bio-Medical Waste Contd…
Option Category of waste Treatment
Category 7 Solid waste (Tubings, catheters, intravenous sets etc.)
Disinfection by chemical treatment autoclaving /microwaving and mutilation/ shredding
Category 8 Liquid waste Disinfection by chemical treatment and discharge into drains
Category 9 Incineration Ash Disposal in municipal landfill
Category 10 Chemical waste Chemical treatment and discharge into drains for liquids and secured landfill for solids
Colour Coding &Type of Container for Colour Coding &Type of Container for Disposal of Bio-Medical WastesDisposal of Bio-Medical Wastes
Color coding
Type of container
Waste category
Treatment options as per
schedule I
Yellow Plastic bag Cat 1, Cat 2, Cat 3, Cat 6
Incineration/deep burial
Red Disinfected container/plastic bag
Cat 3, Cat 6, Cat 7
Autoclaving/microwaving/ chemical treatment
Blue/white translucent
Plastic bag/puncture proof container
Cat 4, Cat 7 Autoclaving/microwaving chemical treatment and destruction/shredding
Black Plastic bag Cat 5 and Cat 9 and Cat 10 (Solid)
Disposal in secured landfill
Disinfection• Reduction in the number of pathogenic microbes so that the
material/object/surface becomes safe for handling • Advantages of Na hypochlorite
– Bactericidal– Virucidal– Easily available – Affordable
• Disadvantages – Corrodes metal – Deteriorates rapidly
Disinfection of GlasswareBlood/plasma/serum/fluids in glass containers - Sample vials - Test tubes• Discard in plastic bins containing 1% sodium hypochlorite ( 10, 000 ppm chlorine)
Disinfected blood/fluids Glassware treated in chromic acid
Wash down with running tap water Dry in hot air oven ( Temp 160C)Wash thoroughly
Blood and Blood Products in Blood and Blood Products in Plastic warePlastic ware
– Blood bags Autoclave disposal– Tubings of bags – Microtips – Plastic vials – Microplates – Used blood bags
Immerse in 1% Na Hypochlorite for 30 minutes
Shredding
Safe Disposal of Sharps
• Dispose off your own sharps.• Discard needles in puncture -proof rigid
containers after disinfection in 0.5-1% fresh sodium hypochlorite solution.
• Don’t dispose in any other container.• Dispose when container is 3/4 full.
AutoclaveAutoclave• Saturated steam under pressure is used to decontaminate
infectious material. • It consists of a insulated pressure chamber in which saturated
steam is used to elevate the temperature
• A pressure of 15psi at 121oC for 30 minutes is required
• Adequacy of disinfection to be checked with strips of B. Stearothermophilus.
Issues of ConcernIssues of Concern
– Regular sensitization
• Adequate resources– Regular availability of supportive items
• Monitoring mechanisms– Indicators