CONTROLLED DOCUMENT O EMBOSSED PAPER COPIES TO BE … … · 3.1.1 UPS S06/14 COSHH 3.1.2 UPS...

CONTROLLED DOCUMENT – ONLY EMBOSSED PAPER COPIES TO BE USED BEYOND DAY OF PRINTING

Approved Enter a date. OMB-M 002 Version 1.14 (Draft) of 19

Printed 16/12/2014

YOU ARE INSTRUCTED TO READ THE FOLLOWING THOROUGHLY BEFORE PROCEEDING TO

UNDERTAKE THE METHODS DESCRIBED.

UNDER NO CIRCUMSTANCES ARE THESE INSTRUCTIONS TO BE AMENDED OR ALTERED IN ANY

WAY OTHER THAN BY THE AUTHOR / APPROVER.

Title: OMB Health and Safety Manual

Serial Number: OMB-M 002 Version Number: 1.14 (Draft)

Version Approver: Enter name Version Approval Date: Enter a date

Version Effective: On release

Version Author: Gareth Bicknell Version Date: 08/09/2014

Area of Application: All areas of OMB activity Relevance: All OMB Staff, and all OMB Team members/visitors working in OMB areas.

Date Details of Review Version number

No. of pages

Name of Reviewer Next Review

25/03/10 New manual by Karolina Kliskey

1.0 26 Matthew Burgess, Stefanie Garden

24/03/11

08/09/14

Reformatted. Imported paragraphs formerly in Training Manual, general updates.

2.0 19 Gareth Bicknell, Karolina Kliskey



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Table Of Contents

1 PURPOSE .......................................................................................................... 3

2 DEFINITIONS ..................................................................................................... 3

2.1 COSHH ................................................................................................................. 3 2.2 DSE ....................................................................................................................... 3 2.3 DSO ...................................................................................................................... 3 2.4 PPE ....................................................................................................................... 3 2.5 OMB STAFF ............................................................................................................ 3 2.6 OMB TEAM ............................................................................................................. 4

3 REFERENCES AND /OR KEY DOCUMENTS ................................................... 4

3.1 UNIVERSITY OF OXFORD POLICIES ........................................................................... 4 3.2 OMB POLICIES AND MANUALS ................................................................................. 4 3.3 OMB SOPS ............................................................................................................ 4 3.4 OMB RISK ASSESSMENTS & COSHH ...................................................................... 5

4 RESPONSIBILITIES ........................................................................................... 5

5 STANDARD RULES ........................................................................................... 6

6 PATIENT AREA RULES .................................................................................... 7

7 LABORATORY RULES ...................................................................................... 8

7.1 GENERAL LABORATORY RULES ................................................................................ 8 7.2 ADDITIONAL RULES REGARDING EQUIPMENT AND REAGENTS .................................... 9 7.3 PERSONAL PROTECTIVE EQUIPMENT (PPE) ............................................................ 10

8 COSHH AND OTHER RISK ASSESSMENTS ................................................. 11

9 DISINFECTION AND DECONTAMINATION PROCESSES ............................ 12

10 FIRST AID AND MEDICAL EMERGENCIES ................................................ 12

10.1 GENERAL PROCEDURES ........................................................................................ 12 10.2 SHARPS/NEEDLESTICK INJURY ............................................................................... 13 10.3 SPLASH INCIDENTS WITH BODY FLUIDS ................................................................... 13 10.4 SPLASH INCIDENTS WITH CHEMICALS ..................................................................... 13

11 FIRE EMERGENCIES ................................................................................... 14

11.1 FIRE TRAINING AND PROCEDURES .......................................................................... 14

12 MAJOR SPILLAGE EMERGENCIES ........................................................... 16

13 REPORTING AND MONITORING OF ACCIDENTS AND INCIDENTS ....... 18

13.1 RESPONSIBILITIES ................................................................................................. 18 13.2 REPORTING MECHANISMS ...................................................................................... 18 13.3 MONITORING ......................................................................................................... 18



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1 Purpose

1.1 The purpose of this document is to provide information for OMB Staff, Team and

visitors regarding all aspects of health and safety within the Oxford

Musculoskeletal Biobank (OMB).

1.2 Most health and safety procedures and considerations in this document refer to

procedures carried out in the OMB Laboratory. However, some apply to the office

envrionment.

2 Definitions

2.1 COSHH

2.1.1 Control of Substances Hazardous to Health – the regulations covering the

strorage, handling, use, and disposal of anything that is inherently harmful to

human health. Supplemented by other regulations, such as DSEAR (Dangerous

Substances and Explosive Atmospheres Regulations), which cover anything

that is not inherently harmful to human health, but may nonetheless present a

risk to human health and safety through other properties.

2.2 DSE

2.2.1 Display Screen Equipment – equipment and regulations that cover the use of

equipment requiring a display screen (e.g. computers).

2.3 DSO

2.3.1 Departmental Safety Officer – a University staff member to whom departmental-

level duties are delegated by the Head of Department.

2.4 PPE

2.4.1 Personal Protective Eqiupment – equipment designed specifically to reduce the

impact on the worker of the failure of other hazard controls, such as

containment. PPE is regarded as the last resort of reducing risk, not the first.

2.5 OMB Staff

2.5.1 Core members of OMB regarded as required for the biobank to function. Not to

be confused with the generic term “staff”.



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2.6 OMB Team

2.6.1 Members of OMB who, through their roles, require training to be documented by

OMB, but who are not necessarily regarded as OMB Staff (e.g. non-core

consenters, or researchers who cannot avoid having access to identifiable

patient data).

3 References and /or Key Documents

3.1 University of Oxford Policies

3.1.1 UPS S06/14 COSHH

3.1.2 UPS S04/14 Arrangements for First Aid on University Premises

3.1.3 UPS S03/14 Fume Cupboards

3.1.4 UPS S01/14 Accident, Incident, Disease and Near Miss Reporting

3.1.5 UPS S05/11 Hazardous Waste Disposal

3.1.6 UPS S08/10 Eye Protection

3.1.7 UPS S08/09 Display Screen Equipment Regulations 1992

3.1.8 UPS S07/09 Respiratory Protective Equipment (RPE)

3.1.9 UPS S05/09 Biorisk Management

3.1.10 UPS S05/09 Appendix 3 Bloods Additional Rules

3.1.11 UPS S01/05 Storage of Flammable Liquids

3.1.12 UPS S04/03 Liquid Nitrogen

3.1.13 UPS S04/01 Unattended Operation of Apparatus and Equipment

3.2 OMB Policies and Manuals

3.2.1 OMB-P 008 OMB Disposal Policy

3.2.2 OMB-M 004 Staff Induction and Training Log Book

3.3 OMB SOPs



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3.3.1 Master copies are available online. Official copies are permitted only if

embossed and signed out by the Quality Manager.

NB – copy control is a fundamental requirement of the licence, so avoid making

unofficial copies, because they are invalid beyond the day of printing.

3.4 OMB Risk Assessments & COSHH

3.4.1 Copies are available in the OMB Risk Assessments and COSHH folder in the

laboratory for procedural/material assessments, or in individual OMB Training

folders for personal assessments (e.g. DSE).

4 Responsibilities

4.1 It is the responsibility of all members of OMB Staff and Team to familiarise

themselves with the relevant statutory, Trust, University, and local health and

safety policies, and to take reasonable care of their own health and safety and

that of their colleagues.

4.2 It is the responsibility of OMB Management, together with the the Departmental

Safety Officer (DSO), to implement health and safety procedures to provide a

safe working environment in accordance with current safety guidelines and

legislation.

4.3 All members of the OMB Staff and Team have a responsibility to report any faults,

risks or incidents, which they think may affect the health and safety or welfare of

themselves or others, to OMB Management or to the DSO.

4.4 It is the responsibility of all OMB Staff, Team members, and visitors to comply

with this document and to take reasonable care of their own health and safety

and that of their colleagues, as outlined in the Trust, University, and local safety

policies.

4.5 OMB Management is responsible for ensuring the implementation of this

document.

4.6 It is the responsibility of the DSO, who should be notified of any problems, to

inspect the OMB Laboratory and other areas of practice at the intervals



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prescribed by the University. The DSO will keep written records kept of all

inspections.

5 Standard Rules

5.1 Remember that even work performed purely in the office is subject to risk – the

most prevalent being trips, musculoskeletal damage from lifting/carrying, and

acute/chronic conditions arising from DSE use.

5.2 Unless purely office-bound, anyone entering the OMB is also subject to the health

risks associated with handling of human tissue samples and other substances.

5.3 All hazardous activities must therefore be covered by a risk assessment. Risk

assessments must be completed in advance of work starting, and they must be

completed in consultation with the OMB Manager or Quality Manager and the

DSO.

5.4 You must take the advised precautions to protect yourself and others whom your

work might affect. The degree of risk will depend on the work undertaken and

observation of safety guidelines.

5.5 Ethical considerations aside, safety rules therefore require that you only allow

authorised individuals to enter and/or work in OMB areas.

5.6 This authorisation is granted only by the OMB Manager or OMB Quality Manager.

5.7 As part of this authorisation:

Never undertake work unless you have received appropriate training, which

may include reference to specific risk assessments. All training must be

signed off before you begin unsupervised work.

Never move heavy or bulky equipment without assistance.

Never run in work areas, especially in the laboratory or along corridors.

Exercise care when opening and closing doors.

Always ensure that work areas are maintained in a reasonable state of

tidiness and cleanliness. Communal apparatus must be left in a decent and



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contamination-free state for the next user. All spills must be dealt with

immediately and in accordance with the disinfection policy.

Always report faults in equipment to the OMB Manager. Always label faulty

equipment clearly to take it out of use.

Always perform safety checks and regular maintenance as required, or

arrange for their service under contract.

5.8 Pregnant and breast-feeding women, and anyone with a musculoskeletal injury

sustained outside of work, should declare their condition to the OMB Manager as

soon as possible, so that an appropriate (re-)assessment of risk can be made.

NB – it is likely that little adjustment will be needed during pregnancy or breast-

feeding, particular regarding biological or chemical hazards, since unborn/breast-

fed children will usually be protected by the same measures already protecting

the mother.

6 Patient Area Rules

6.1 Follow an appropriate dress code. For those unfamiliar with the NHS

environment, this means dressing smartly: never wear flip-flops, open-toed

sandals, or jeans.

6.2 In clinical areas, always observe the “bare below the elbows” rule – clothing

should not cover any area of the arms/hands below the elbow. This reduces the

risk of cross-contamination.

6.3 Unless otherwise advised, use alcohol gel to disinfect hands in between seeing

patients, and when entering or leaving clinical areas.

6.4 If examining patients, always wipe down examination areas (e.g. the examination

couch) in between patients with disinfectant wipes.

6.5 Always keep patient areas clean and tidy.



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6.6 Never use equipment, pharmaceuticals, or perform procedures for which you

have not received at least the minimum professional, statutory or mandatory

training.

7 Laboratory Rules

7.1 General Laboratory Rules

7.1.1 For your protection:

Never eat, drink, chew, mouth-pipette, or apply makeup in the laboratory.

Never lick labels, stamps, pens, pencils or fingers in the laboratory.

Always tie back long hair before work is started.

Always wear sensible footwear, not open-toed shoes or sandals.

Always wash your hands before touching your eyes or mouth, blowing your

nose or going to the toilet.

7.1.2 To help protect yourself and others with whom you come into contact:

Never take personal items such as pens, pencils, brushes and handbags

etc. into the laboratory.

Never take items home if they have been used in the laboratory (e.g. pens,

pencils, laboratory coats).

Never store food in the laboratory.

Always ensure that any form of open wound, especially on the hands, is

covered by a waterproof dressing before work is started.

Always remove contaminated disposable gloves before handling “non-

laboratory” equipment such as telephones, photocopiers, or door handles.

Always wash your hands before changing gloves, going on a break, having

lunch, leaving the department, or after handling specimens, equipment or

paperwork that may have been handled in the laboratory.



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7.1.3 If you think that your hands may have been in contact with biological material,

wash them immediately. If your gloves are perforated during work – even if you

are not injured – remove them, wash your hands, and put on a clean pair.

7.1.4 Never allow visitors to handle specimens, chemicals or equipment without

instruction and supervision from a qualified member of OMB Staff.

7.2 Additional Rules Regarding Equipment and Reagents

7.2.1 In order to reduce risk to your own safety, as well as to others:

Always label reagents clearly, including appropriate warning labels in case of

hazardous chemicals.

Always display warning signs when there is unusual danger (e.g. hot plates

when on, or when cooling).

Always ensure that chemicals and biohazards are handled and stored in

accordance with COSHH risk assessments.

Always enure that all chemicals and equipment kept in the OMB Laboratory

are returned to the appropriate storage locations after use.

Always dispose of laboratory waste material promptly and in a safe manner,

as described by the relevant COSHH risk assessment.

Always transport large volumes of chemicals (>5 litres) using a trolley with

high, chemically-resistant sides.

7.2.2 Remember the “obvious” rules that are easily forgotten:

Never leave apparatus running unattended without first making sure that it is

safe to do so. No equipment should be left unattended out-of-hours (other

than freezers, fridges, and monitoring systems).

Never attempt to override or interfere with safety interlocks on hazardous

equipment.

Never carry large flasks or bottles by the neck. Support them underneath.

Transport Winchester bottles in purpose built carriers.



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Never use cracked or chipped glassware. Exercise great care when

extracting glassware from drawers or cupboards.

Never heat glass that is not of the Pyrex type. Never expose glass blood

tubes to ultralow temperatures.

Avoid sudden changes of pressure when using vacuum apparatus.

7.2.3 See also Sections 8 (COSHH) and 9 (Decontamination).

7.3 Personal Protective Equipment (PPE)

7.3.1 PPE must be worn as determined by COSHH assessment and University

policies.

7.3.2 In general:

Always change PPE when going to a clean area. Always remove PPE when

leaving the laboratory.

Always wear laboratory coats properly fastened when working at the bench

or with the freezers. Laboratory coats are not needed if using computers

purely for administrative work and negligible risk is present from other work

in the laboratory.

Surgical gowns may be worn in place of laboratory coats during educational

courses.

The University requires eye protection to be worn at all times when working

in the OMB Laboratory. Safety spectacles are provided for this purpose.

Anyone needing prescription glasses for laboratory work is exempt from

wearing additional eye protection unless risk assessment determines

otherwise.

Thermal gloves, masks, and face shields are available. Any other PPE will

require ordering.

If your laboratory coat becomes contaminated with a material known or

thought to be infectious, change it immediately. Place dirty coats in a blue



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linen bag for sending to the linen room. Wash your hands before putting on a

clean coat.

NB – Laboratory coats should be changed once a week and hung on the

designated hooks in the OMB Laboratory when not in use.

8 COSHH and Other Risk Assessments

8.1 COSHH and other risk assessments can be carried out by any member of staff

who has sufficient experience and knowledge in the area to be assessed, but

they must always be signed off by OMB Management before implementation or

distribution.

8.2 Risk assessments must be carried out for all procedures in the OMB Laboratory,

and COSHH risk assessments must be performed for all procedures involving

chemicals and biohazards.

8.3 Current assessments can be found online and in the OMB Laboratory Health and

Safety, Risk Assessments and COSHH folder.

8.4 Remember that:

All routine waste disposal from the OMB Laboratory must be in line with the

OUH Waste Management Policy, since disposal is via the Trust’s routes.

Disposal of significant quantities of material not usually handled by the Trust

must be in line with the University Waste Management Policy, since disposal

is via the University’s routes.

8.5 When assessing materials under COSHH, remember that, in gerenal:

Flammable chemicals and waste should be stored separately from oxidising

agents.

The quantity of flammable chemicals stored should not exceed the amount

that can be stored in the flammables cupboard located under the fume hood

in ND19.



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All other flammable chemicals and waste must be stored in the outside

chemical store located outside the Botnar Research Centre.

Acids must only be stored in the acids cupboard located in ND19.

For disinfection and first aid, refer to Sections 9 and 10.

9 Disinfection and Decontamination Processes

9.1 Disinfection is the process of removing or killing most, but not all, viable

organisms through the action of specific chemical agents. Disinfection aims to

reduce the number of micro-organisms to a level at which they are not harmful.

Spores are not necessarily destroyed, depending on the method and the nature

of contaminant being removed.

9.2 An area (e.g. bench top or floor), piece of equipment, or an instrument should be

disinfected as soon as possible after coming into contact with a fresh specimen.

9.3 All equipment must be disinfected and cleaned (“decontaminated”) prior to

servicing in order to remove chemical and biological contamination. Any

equipment being sent outside the department for servicing or maintenance must

be appropriately certified as decontaminated.

9.4 Disinfection (both routine and corrective) must be performed in accordance with

OMB-LSOPs, which are only relevant when working in the OMB Laboratories.

Disinfection in other areas must be in accordance with local safety procedures.

10 First Aid and Medical Emergencies

10.1 General Procedures

10.1.1 The designated OUH first aider can be contacted by bleeping 101 via the

switchboard. The first aider can also be contacted following any accident or

incident to offer advice and support.

10.1.2 If immediate first aid is required before the first aider can be contacted, you

should contact the nearest qualified nurse or medic.



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10.1.3 A first aid kit is located in the OMB Laboratory (ND18) next to the wall-mounted

cupboard. All cuts or abrasions, however small, must be covered with a

waterproof adhesive dressing.

10.1.4 In the event of an emergency, dial the following numbers:

Cardiac arrest and medical emergencies: 2222

Fire and other emergencies: 4444

10.1.5 Report the incident as detailed in Section 13.

10.2 Sharps/Needlestick Injury

10.2.1 Encourage bleeding of the wound without further damaging it.

10.2.2 Wash the wound well with soap under running water and then cover it with a

waterproof dressing.

10.2.3 If the instrument causing the wound was used/dirty, contact Occupational Health

on 20798 (out of hours, contact the on-call microbiologist via the switchboard on

0).

10.2.4 If the instrument causing the wound was unused/clean, contact the first aider via

bleep 101.

10.3 Splash Incidents with Body Fluids

10.3.1 If splashed into your mouth, do not swallow, but rinse your mouth several times

with cold water.

10.3.2 If splashed into your eyes, irrigate them well with eye-wash or running water for

10-15 minutes.

10.3.3 Contact Occupational Health on 20798 (out of hours contact the on-call

microbiologist via the switchboard on 0).

10.3.4 If splashed onto broken skin, wash immediately and contact the first aider via

bleep 101.

10.4 Splash Incidents with Chemicals



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10.4.1 COSHH risk assessment will have determined correct procedures, and you

must have familiarised yourself with it prior to performing the work.

10.4.2 As a general principle, however, if splashed into the mouth, do not swallow or

induce vomiting, but rinse the mouth several times with cold water (unless the

person is unconscious).

10.4.3 If splashed into the eyes, remove contact lenses, and irrigate eyes well with eye-

wash or running water for 10-15 minutes.

10.4.4 If splashed onto the skin, wash solids off with soap and water, or irrigate liquids

with plenty of water for at least 10-15 minutes, and remove affected clothing.

10.4.5 If the splash is minor contact the first aider for advice.

10.4.6 In the event of a major splash seek medical advice immediately.

11 Fire Emergencies

11.1 Fire Training and Procedures

11.1.1 Fire training is statutory (i.e. compulsory throughout the UK). All OMB staff must

attend OUH fire training annually in the manner prescribed by the Trust.

11.1.2 On identifying a fire, activate a fire call point and call 4444, giving details of the

alarm’s location.

11.1.3 Only attempt to combat the fire if it is low risk for you to do so, and only if you

are competent and confident to do so.

Red panel – water for wood/paper/textiles – remember that the jet may need

finger control to avoid knocking over target objects.

Black panel – CO2 for flammable liquids/electrical – remember that the horn

rapid attainins flesh-freezing temperatures, and that you should avoid use in

confined spaces.

11.1.4 On hearing an alarm, remember that there are two types of “real” alarm:



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An intermittent/pulsing alarm warns of fire in an adjacent zone – prepare

to evacuate your zone.

NB – As an OMB Team member, you are unlikely to be expected to help

with evacuation preparations in clinical areas, but the decision of the local

Fire Warden/Trust Fire Team is final and must be respected.

A continuous alarm warns of fire within your zone – evacuate to Assembly

Point B in front of the Tebbit Centre for roll call, or (if working outside

NDORMS) to an adjacent zone.

NB – As an OMB Team member, you are unlikely to be expected to help

with evacuation of patients from clinical areas, but the decision of the local

Fire Warden/Trust Fire Team is final and must be respected.

11.1.5 When evacuating, always pick the most direct safe route. There are two exits

from the NDORMS corridor.

Back out to the main NOC Level 2 corridor

Opposite the door of ND18

11.1.6 Exits from other locations on the NOC site (and on other OUH sites) are beyond

the scope of this document, but you must ensure that you are aware of all

possible local exits.

11.1.7 Never use the lifts during any fire-related evacuation.

11.1.8 On arrival at the assembly point, the Fire Warden or NDORMS Manager will

commence roll call and alert the Trust Fire Team of any absentees.



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12 Major Spillage Emergencies

12.1 A major spillage of dangerous chemicals such as formalin, Industrial Methylated

Spirits (IMS), xylene, acids or ammonia, or pathological specimens (whether fixed

or unfixed) could cause a serious health hazard. The quantity of liquid chemical

that constitutes a major spillage is dependent on the type of chemical involved,

due to the emission of fumes given off by some chemicals, the risk to health and

the risk of fire. For example, a 500 ml spillage of ammonia or acid would present

a greater hazard than a 500 ml spillage of IMS.

12.2 The decision to tackle a major spillage is discretionary. A spillage should only be

tackled if it is considered manageable, and if there is minimal risk to yourself and

others. It should always be tackled as described by the relevant COSHH risk

assessment.

12.3 However, there are certain common points to tackling all major spills:



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Evacuate the area or room.

Make others aware of the spill using signs.

Wear PPE including a laboratory coat, plastic apron (of a type suitable for the

chemical clean-up required), gloves (of a type suitable for the chemical clean-

up required), safety goggles, and suitable extra foot protection (shoe

protectors or wellingtons, depending on the chemical). If harmful fumes are

emitted a respiratory mask (of a type suitable to the chemical clean-up

required) must be worn.

Ventilate the area.

Soak up liquid spills with inert spillage granules or sand. A spill kit is available

under the sink in ND-18.

Once liquids have been fully absorbed, sweep up the granules and deposit

them in a rigid container for specialist disposal.

Report the incident as detailed in Section 13.

12.4 In the unlikely event of a large chemical or specimen spill on you or your clothes

you should:

Remove as much contaminated clothing as possible and wash yourself

immediately under the shower located in the male/female changing rooms.

Obtain first aid/advice as detailed in Section 10.

12.5 In the event of a major spill that cannot be dealt with you should:

Evacuate the area.

Contact the University and Trust safety teams to arrange further action. If

there is an immediate risk of explosion or fire you must raise the fire alarm by

dialing 4444.



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13 Reporting and Monitoring of Accidents and Incidents

13.1 Responsibilities

13.1.1 If you are involved in a near-miss, an accident, breakage of equipment, or a

spillage of clinical material or chemicals, you must report the incident to a OMB

Management immediately.

13.1.2 Visitors should not themselves attempt to carry out decontamination or deal with

spillages or breakages.

13.1.3 OMB Management must ensure that the correct “first contacts” are made.

Provided this is done, any subsequent required notifications will happen

automatically.

13.2 Reporting Mechanisms

13.2.1 All accidents and incidents must be reported on a Non-Conformity Note (OMB-F

034), as per OMB-MSOP 014 – Identificaiton and Control of Non-

Conformities. This ensures that all incidents – regardless of location – are

entered into the Quality Management System in a consistently-traceable way.

13.2.2 All accidents, incidents, and near-misses occurring in University areas must be

reported on a University incident form held at the Botnar Reception. This

ensures that the DSO and University Safety Office are informed. Serious

incidents must also be notified immediately by telephone on 01865 270811 (or

out-of-hours, 01865 289999).

13.2.3 All accidents, incidents, and near-misses occurring in Trust areas must be

reported via the Trust’s online incident form (DIF1) on the Datix incident

reporting system located on the OUH intranet. This ensures that the OUH Safety

Team(s) are informed.

13.2.4 When appropriate (e.g. a member of OUH Staff being inoculated in a University

laboratory), cross-reporting must be initiated. This will usually happen at the

behest of the organisation to which the primary safety report is sent.

13.3 Monitoring

http://oxnetdatixweb/datix/live/index.php



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13.3.1 Incidents will be followed up (if follow-up is necessary) by the relevant safety

office/teams.

13.3.2 All incidents should be reported up to the OMB Management meetings and at

annual review.

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