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Hazardous Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Hazardous and links to relevant pages within the course.

Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.



General Laboratory Question Bank - Review Mode (no CE)
What type of protective gear must be worn as a minimum when working with hazardous chemicals:View Page
Standard precautions means that:View Page
Which section of the MSDS would provide information on chemical hazards that might affect your health:View Page

Introduction to Bioterrorism
Why Biological Agents Would be Chosen as WMDs (cont.)

They can have a psychological impact.Biological WMD's could possibly have a psychological impact that will go far beyond their actual effect. The very thought of exposure to a biological agent may possibly cause many people to panic. Biological WMDs can tie up resources.Some biological agents can be a hazard for lengthy periods. The use of these agents may require tedious, time-consuming, resource-intensive decontamination and monitoring of facilities before they can be returned to service.Defense may be difficult.It is very difficult for civilian government agencies to prepare for biological terrorist incidents. While most civilian agencies have some kind of hazardous material or HAZMAT response teams; in the event of a biological terrorist incident, these teams are likely to be challenged beyond their capability in terms of human resources, and equipment.

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Why Biological Agents Would Not Be Chosen as WMDs

They are not immediate. The delayed effect, for example, the long incubation period for some agents, may detract and limit their tactful usefulness as a political statement.They are hazardous to all who come in contact.There is the possibility that the biological agents could also affect the health of the aggressor forces.They are hard to control.The dependence of prevailing winds and other weather conditions such as temperature, sunlight, and desiccation may make it difficult to control distribution of the biological agent.Potential long term effects beyond the initial attack.The persistence of some agents such as spore-forming anthrax in the environment may make an area uninhabitable to aggressor forces for long periods.Results are unpredictable.Morbidity secondary to a biological attack is unpredictable since casualties will be related to the quantity and manner of exposure plus the preventive and treatment measures available.

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OSHA Bloodborne Pathogens
How Easily is HIV Transmitted?

After an exposure to HIV, the chance of becoming infected is usually less than 1%. However, blood and body fluid that contains high numbers of viral particles are more hazardous. Because of the extremely serious nature of HIV, it is vital to take every precaution to avoid workplace exposure.

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OSHA Bloodborne Pathogens (retired)
How easily is HIV transmitted?

After an exposure to HIV by a contaminated needle, the chance of becoming infected is usually less than 1%.However, exposures from patients with high numbers of viral particles in their blood may be more hazardous.Because of the extremely serious nature of HIV, we must take every precaution to avoid workplace exposure.

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OSHA Electrical Safety (retired 11/19/2012)
Ground

A ground is a conducting connection between an electrical circuit or equipment and the earth, or between an electrical circuit and some conducting body that serves in place of the earth.The purpose of a ground is to prevent the buildup of voltages that may result in a hazardous situation for the connected equipment and/or for the person operating the equipment.All electrical equipment in the laboratory that is not clearly marked as "double-insulated" must be grounded by using a three-pronged power cord.

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OSHA Hazard Communication and Chemical Hygiene Updated to the Globally Harmonized System
Goals of this Program

Locate potentially hazardous chemicals in your workplace. Explain how to obtain a copy of a material safety data sheet (MSDS). Explain the information included on chemical labels. Identify exposure control measures.The intent of th to recognize potentially hazardous chemicals in the workplace, be able to locate the paper copies of material safety data sheets (MSDSs) in the laboratory, or know how to obtain an electronic copy of an MSDS when needed. The goals also include able to explain the information that is included on chemical labels and choose to use engineering controls, personal protective equipment and safe work practices to avoid exposure to hazardous chemicals.

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Right to Know

As an employee, you have the right to know the types of hazardous substances that are used in your workplace. Material safety data sheets are now referred to as safety data sheets (SDSs) under the Globally Harmonized System of Classification and Labeling of Chemicals (GHS). SDSs must be available to you for each chemical used in the laboratory, either in paper or electronic form. Ask your supervisor for the exact location.

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Section Four

This section includes important first aid information that you will need if you, or someone else, comes into contact with the chemical.

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Personal Protective Equipment

Personal protective equipment is an essential way to protect yourself from the dangers of chemicals. You'll find on the label or safety data sheet (SDS) exactly what kinds of clothing, gloves, and coverings you'll need to keep yourself safe. Also, the laboratory's chemical hygiene plan will include information about necessary personal protective equipment and engineering controls that will reduce your exposure to hazardous chemicals. At a minimum, chemical safety goggles and rubber or nitrile gloves (not necessarily utility gloves) are necessary parts of your personal protective equipment.

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Monitoring

Certain chemicals in use in the laboratory, such as formaldehyde, are hazardous if your exposure to them is prolonged. The amount of the chemical to which you can be exposed before possible danger is called the threshold limit value. Monitoring badges are used from time to time to measure your exposure. These are worn in the "breathing zone" for a certain period of time--often eight hours (for long-term exposure) or fifteen minutes (for short-term exposure). Based on the results of this monitoring, additional personal safety measures, such as ventilation or face-fitted masks, may be implemented for your protection.

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Common Sense Rules, continued

Also remember to: Learn basic first aid measures.Read chemical labels.Read safety data sheets (SDSs).Follow warnings and instructions.Use the correct engineering controls and personal protective equipment.Practice sensible, safe work habits.Be knowledgeable about your laboratory's chemical hygiene plan and the location in your laboratory of all reference materials on the hazards, safe handling, storage, and disposal of hazardous chemicals, including the location of SDSs.Know the location of the eyewash stations that are closest to the areas where chemicals are handled and know how to use the eyewash correctly.Know the location of spill kits.

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Packaging and Shipping Infectious Materials
Who Must Receive Training?

According to federal and international regulations, all personnel who are involved in the packaging and shipping of infectious materials are required to have training. This includes anyone who:Packages, labels, and/or marks the package Is responsible for classifying the materials Is responsible for documenting the package contents on a shipper's declaration for dangerous goods form, air waybill, etc. Signs a shipper's declarationTransports hazardous materials by vehicle, plane, or vesselThe training that is required for individuals who package and ship only category B infectious substances is not as comprehensive as the training required for individuals who may package and ship category A infectious substances.

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What are the Training Requirements?

The training requirements that are stated in the US Code of Federal Regulations at 49 CFR 172.704 must be met by all personnel who are involved in shipping hazardous materials in the United States and training must be completed within 90 days of employment or performance of the required hazmat function (relevant documented training from a previous employer is acceptable).These requirements include: General awareness/familiarization training Function-specific training Safety training Security awareness training (Category A substances) Safety training, must be provided by the facility where the infectious materials are packaged and must include: Emergency response information Measures to protect the employee from the hazards associated with hazardous materials to which they may be exposed in the work place, including specific measures the hazmat employer has implemented to protect employees from exposure Methods and procedures for avoiding accidents, such as the proper procedures for handling packages containing hazardous materials OSHA bloodborne pathogens training is generally sufficient to meet this requirement for packaging and shipping infectious materials.

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Classifications of Hazardous Materials

The US Department of Transportation (DOT) classifies hazardous materials according to the risks that they pose. There are nine hazard classes: Class 1: Explosives Class 2: Gases Class 3: Flammable liquids Class 4: Flammable solids Class 5: Oxidizers/organic peroxides Class 6: Toxic and infectious substances Class 7: Radioactive material Class 8: Corrosives Class 9: Miscellaneous hazardous materials Within class 6 are two divisions: Division 6.1- poisonous material Division 6.2- infectious substanceA division 6.2 infectious substance is defined as a material known or reasonably expected to contain a pathogen. A pathogen is a microorganism or other agent (e.g., a prion) that can cause disease in humans or animals. The regulations that govern packaging and shipping a class 9, miscellaneous hazardous material, may also need to be reviewed by those who package and ship laboratory specimens. Dry ice is a class 9 hazardous material and, if used, requires special packaging, and specific labeling and marking on the outer package.

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Categories of Division 6.2 Infectious Substances

Hazardous material classifications are consistent across all agencies who regulate commercial shipping and are based on criteria developed by the United Nations (UN) Committee of Experts working with the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), medical professionals, microbiologists, transportation professionals, and packaging technical experts. These requirements can be found in the 13th and 14th editions of the United Nations Recommendations for the Transport of Dangerous Goods, the 2005 - 2006 edition of the International Civil Aviation Organization Technical Instructions for the Safe Transport of Dangerous Goods by Air (ICAO Technical Instructions), and the International Maritime Organization (IMO) Dangerous Goods Code. The classification system for Division 6.2 Infectious Substances includes two catergories, known simply as Category A and Category B.

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IATA and US Postal Service Exempt Specimens

Laboratory specimens that are unlikely to cause disease and do not meet the criteria for category A or B substances are not subject to Division 6.2 regulations. Specimens for which the hazardous materials regulation (HMR) does not apply include human or animal samples (including, but not limited to, secreta, excreta, blood and its components, tissue and tissue fluids, and body parts) being transported for routine testing not related to the diagnosis of an infectious disease. This includes specimens that are being sent for:drug or alcohol testing cholesterol testing blood glucose level testing prostate specific antibody (PSA) testing testing to monitor kidney or liver function pregnancy testing tests for diagnosis of non-infectious diseases such as cancer biopsies The US Department of Transportation (DOT) has no "Exempt Specimen" classification and there are no DOT guidelines for packaging non-regulated specimens.* According to the DOT, in the U.S., if a package is marked as "Exempt Human/Animal Specimen" the understanding is that it contains no infectious substance. However, both IATA and the US Postal Service (USPS) have these requirements for packaging exempt specimens: Packaging IssueIATAUSPSType of packaging requiredTriple packagingTriple packagingOuter containerOne dimension must be a minimum of 100 mm X 100 mm (approximately 4 x 4 inches) Must be able to survive a drop test of 4 feet One dimension must be a minimum of 100 mm X 100 mm (approximately 4 x 4 inches) Must be able to survive a drop test of 4 feet Quantity limits: outer containerNone NoneQuantity limits: Primary receptacleNone500 mLQuantity limits: secondary packagingNone500 mL* Non-regulated specimens may become regulated because of preservatives, such as 10% formaldehyde (class 9) or 25% formaldehyde (class 8); or 25% ethanol (class 3).

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Additional Packaging Requirements for Category A and Category B Substances

If multiple primary receptacles are placed in a single secondary packaging, they must be either individually wrapped or separated so as to prevent contact between them.The primary receptacle or the secondary packaging must be capable of withstanding, without leakage, an internal pressure producing a pressure differential of not less than 95 kPa (13.8 lbs/in2) because the package may be placed into an unpressurized storage compartment in a cargo aircraft. This must be verified when choosing packaging for shipping either category A or category B substances by aircraft. It is also recommended if shipping by ground. An evacuated blood collection tube that has remained unopened qualifies as a 95 kPa container. The smallest surface of the outer packaging must be at least 100 mm X 100mm (4 inches x 4 inches).Other dangerous goods must not be packed in the same packaging as Division 6.2 infectious substances unless they are necessary for preservation of the specimen (e.g., formalin). A quantity of 30 mL or less of formalin or other dangerous goods included in hazard Classes 3, 8, or 9 (flammable liquids such as alcohol; corrosives such as acids or bases; or miscellaneous hazardous materials) may be packed in each primary receptacle containing infectious substances. A quantity greater than 30 mL will require appropriate hazard labels on the package.OverpackWhen packages are placed in an overpack, the overpack must be marked with the word "Overpack" and the package markings must be reproduced on the outside of the overpack.

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Dry Ice

If dry ice is used as a refrigerant, it must be placed outside the secondary packaging. Interior supports must be provided to secure the secondary packaging in the original position after the dry ice has dissipated. The packaging must be designed and constructed to permit the release of carbon dioxide gas to prevent a buildup of pressure that could rupture the packaging. A "miscellaneous hazardous materials" label (class 9) must be affixed to the outer package along with a "dry ice" label that includes the UN designation "UN 1845." The net quantity (weight) of the dry ice must also be stated. If the package (category B or exempt substance) is sent through the mail, the amount of dry ice that can be used is limited to 5.5 pounds, unless advanced arrangements have been made. The quantity limit that complies with IATA regulations is 200 kg/441 lbs.

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Security Awareness

A category A infectious substance is in a form that is capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs. Exposure would occur if the substance were released from its protective packaging and a human or animal came into contact with it. Therefore, it is critical that a category A infectious substance does not end up in the hands of an unauthorized individual who may purposely or unknowingly release the substance from its protective packaging and endanger humans or animals. Being aware of the people that you interact with in the process of packaging and sending category A substances is vital to the safety of the transport and prevention of a health disaster. An outsider with limited access and system knowledge could constitute a threat, but be aware that insiders could also be a threat, e.g., a disgruntled employee or a person who is angry with his or her supervisor or job or the government. Anyone desiring to do harm could potentially seize the opportunity to steal a hazardous material.Follow these precautionary procedures: When you are questioned about an infectious substance that you are packaging for shipment, it is important that you know the person that is asking AND that he or she has a need to know. If you do not know the person and if you are not aware that the person needs to know about the substance that is being shipped, do not answer the questions. You could refer him or her to your supervisor. Watch for unusual behavior. Secure the package until it is picked up. Check the identification of the courier who will be picking up the package. Use an intralaboratory chain of custody procedure if the specimens are tranferred within the facility or system. Track the package once it has been sent to be sure it arrives safely. Notify the Responsible Official or federal authority if the package does not arrive at its destination.

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Security Plan for Category A Infectious Substances

Each facility that stores and transports hazardous materials must have a written, detailed security plan. The Select Agents and Toxins Security Information Document that was prepared by the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Agriculture, Animal and Plant Health Inspection Service (APHIS) is an excellent resource to use for developing a security plan that would apply to category A infectious substances. This document can be found at http://www.selectagents.gov/resources%5CSecurity%20Information%20Document.pdfThe current version, dated March 8, 2007, is available in this course as a resource. However, because the document does undergo revisions, it is recommended that the URL given above be checked periodically for document updates.

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References

International Air Transport Association. Guidance document: Dangerous Goods Regulations (DGR). 52nd ed. 2011.National Laboratory Training Network. Packaging and shipping Division 6.2 materials. Georgia Public Health Laboratory; 2011. Sentinel laboratory guidelines for suspected agents of bioterrorism: Clinical laboratory bioterrorism readiness plan. Available at: http://stanfordhospital.org/PDF/bioterrorism/labGuidelinesSuspectedAgentsBT.pdf. Accessed January 31, 2011.US Department of Transportation Pipeline and Hazardous Materials Safety Administration. Transporting Infectious Substances Safely. Available at http://www.phmsa.dot.gov/staticfiles/PHMSA/DownloadableFiles/Files/Transporting_Infectious_Substances_brochure.pdf.

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Phlebotomy
Hazardous waste disposal

All needles & other sharps must be disposed of in approved sharps disposal containers. Other contaminated waste must be discarded in an appropriate red biohazard bag or waste receptacle.

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Preliminary Identification of the Primary Select Agents of Bioterrorism
Why Certain Agents are Used as Weapons of Mass Destruction (WMD)

There are many reasons why certain agents would be selected for use in bioterrorist attacks, including the:Ease of availability: Biological pathogens can be obtained from nature, hospital laboratories, and university research facilities. Difficulty to detect: Small quantities can have potentially deadly or incapacitating effects on a susceptible population. Covert use of the agent: Can be spread throughout large areas by natural convection, air, or water currents. Ease in disseminating: Pathogens can be spread through ventilation systems in buildings. Transportation facilities could become part of the dissemination system by carrying biological agents far from their initial source. Psychological impact: Biological WMD’s could possibly have a psychological impact that will go far beyond their actual effect. The very thought of exposure to a biological agent may possibly cause many people to panic. Ability to tie up resources: Some biological agents can be a hazard for lengthy periods. The use of these agents may require tedious, time-consuming, resource-intensive decontamination and monitoring of facilities before they can be returned to service. Difficulty to defend against attack: It is very difficult for civilian government agencies to prepare for biological terrorist incidents. While most civilian agencies have some kind of hazardous material or HAZMAT response teams; in the event of a biological terrorist incident, these teams are likely to be challenged beyond their capability in terms of human resources, and equipment.

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Bacteria, viruses, or toxins that are chosen as weapons of mass destruction (WMD) by bioterrorists are:Easy to acquire and spread Hard to detect and defend against Capable of causing mass panic, injury, and/or deathView Page

Reading and Reporting Gram Stained Direct Smears
Under-decolorized or Over-decolorized Smears

Although this smear is the proper thickness, it is not appropriate for examination because the host cells are stained blue instead of red, indicating that the smear was under-decolorized. In addition, small flecks of precipitated stain are present. Notice that the precipitated stain is irregular in shape, which helps differentiate the flecks from bacteria. A slide is also not acceptable for examination if microorganisms that should be gram-positive appear pink. This may indicate that either the Gram's iodine was not applied or the slide was over-decolorized. Staining gram-positive and gram-negative control slides along with the patient's smear would confirm that proper staining technique was used. If it is impossible to prepare a new smear, the poorly stained smear may still be salvaged. Remove immersion oil from the smear using xylol. Use appropriate procedures and personal protective equipment when using xylol, since it is a hazardous chemical. If the smear is under-decolorized, repeat the decolorization and counterstain steps. If the smear is over-decolorized, the slide should be stained again.

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Reading Gram Stained Direct Smears
Evaluation of Controls

If stains and technique are adequate, S. aureus should be Gram positive (blue) and E. coli should be Gram negative (pink). If control slides do not react appropriately, reliable results cannot be assured for the specimen smears. Check stains and technique and prepare more control smears until proper results are achieved, then remake and stain the new direct smears. If it is impossible to prepare a new smear, the poorly stained smear may still be salvaged. Remove immersion oil from the smear using xylol. Use appropriate procedures and personal protective equipment when using xylol, since it is hazardous chemical. If the smear is underdecolorized, repeat the decolorization and counterstain steps. If the smear is overdecolorized, the slide should be stained again.

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