Even before diagnostic procedures, safety is an important part of laboratory practice. 

Not only in the hematology department but also in every department of the clinical laboratory, the safety of workers, patients, visitors, administrators, and housekeepers in the laboratory must be put first. 

The laboratory is the infected area of ​​the hospital, where samples can be collected and analyzed. 

Therefore, all people who work or visit only in every corner and every inch are at risk of being infected, and the equipment may also spread some kind of infectious disease. 

It is wise to treat the laboratory as a "pathogen zoo" to take effective and necessary preventive measures to minimize the risk of injury. 

Is the effective control of all hazards that exist in the clinical laboratory at any time. 

Is the potential cause harm to people or the natural environment. 

The existence or the reasonably anticipated existence of blood or other potentially infectious materials on the object or surface. 

Most accidents occur due to: 

What are the overall potential Hazards in the hematology laboratory? 

- Fire hazards 

Many laboratory workers face biological hazards every day, which is an occupational hazard. 

These hazards exist in different sources throughout the laboratory, such as blood and body fluids, culture specimens, human tissues and corpses, laboratory animals, and other infected workers. 

 

In a typical clinical laboratory, the worker may only be exposed to geographically prevalent and common pathogens in the community; but, in a research hematology laboratory the level of risks increases exponentially exposing the worker to the most virulent and dangerous pathogens like: 

● HBV 

● HCV 

● HIV 

● EBOLA 

● Avian flu 

● Anthrax 

● Fungi 

● SARS 

The blood is the most important tissue in the body; it is the body’s highway system linking every organ with one another; thus, there is a high risk for the collection of dangerous pathogens of every kind inside it. 

Therefore, even all samples must be considered infectious; blood is the most infectious. 

The best example is HIV. Because the concentration of the virus in the blood is higher than any other human sample. 

Therefore, blood samples and hematology departments have a high risk of infection to workers and visitors alike. 

- Appropriate training of laboratory personnel in the protocol of Hazard prevention and available reading materials like safety guidance documents must be available in a lab or the library from the authorized organization of the country in which the worker practices. 

- Appropriate Personal protective equipment procedures must be followed by the workers at all times like gloves, gowns, splash guard helmets, or goggles when opening vials which contain blood samples. 

 

- There must be a written standard operating procedure and placed in the laboratory according to the lab protocol for the analysis of samples and that must be followed strictly. 

- Employers must provide workers with preventive measures such as HBV and TB vaccines for free, which are actually part of the workers’ rights list. 

- The laboratory manager is responsible for the organization and safety of laboratory hygiene. Thus, he must overlook the safety protocol. 

- Implement procedures appropriate to the skills of workers, that is, workers should not practice or analyze samples beyond the scope of their training. 

- Physicians must be notified of workers that incurred injury like needle stick injury; so that workers can get suitable medical attention and reduce the transmission of pathogens from worker to worker. 

- In advanced research on laboratory animals; particular care and regulation of research must be followed to prevent infection from the target animals. 

- Do not eat, drink, smoke, touch contact lenses, apply cosmetics, or take medicines in the area where blood samples are to be processed. 

- Do not put your hands on your mouth, nose, and eyes. 

- Infectious samples must be labeled ‘infectious’. 

- Always follow the latest research on safety procedures, these publications come from reliable organizations that regulate safety and conduct research on infectious diseases. 

- Safely purify and dispose of biological waste. 

- The safety cabinet must be used appropriately according to the risk of pathogens. 

- Be careful when using sharp objects (such as needles) whenever possible. Don’t remove, recap, bend, break, or clip used needles from disposable syringes. 

- Laboratory cleaning workers other than pathologists need to be trained efficiently on how to clean the benches, microscopes, ESR tubes, slides, and other laboratory equipment with the suitable operating manual and chemicals for each device. 

- Cleaners are more susceptible to infections than workers and therefore have the greatest risk of infection. 

Therefore, they need to receive good training on the pathogenesis of viruses and bacteria, and as mentioned above, which chemicals they should use for disinfection. 

- Wear tear-resistant gloves to prevent exposure. Small tears in the gloves may compromise the protection they offer. 

Take off gloves and wash hands according to the standard after handling patient samples. 

- Use appropriate methods to put on and take off gloves. 

- Use mechanical pipetting devices (no mouth pipetting). 

- The laboratory must have an emergency management plan ready for any potential accidents with samples. 

In hematological procedures the chemicals used are dangerous and corrosive that can cause burns like HCL which is used in hemocytometry of WBC; chemicals like methanol can lead to blindness by damaging the optic nerve; it is used as a fixative in Giemsa staining procedure in parasite diagnosis. 

Other harmful chemicals are bleach and formaldehyde which are used for disinfection of the benches with 1:10 dilution in case of hypochlorite and formaldehyde used as a fumigant agent to sterilize incubators. 

The list of harmful chemicals in all of the laboratory is large there are carcinogens, explosives, caustic, and irritants based on their nature. 

- Label all chemicals correctly; do not use unlabeled chemicals, do not guess. 

- Chemical name, concentration, preparation date, expiration date, name of the producer, and chemical label based on the nature of the chemical, such as toxic, corrosive, or flammable. 

- Follow all instructions regarding chemical handling and storage requirements that came with the manufacturer called ‘material safety data sheets’ which can be stored and read later on to understand the purchased chemicals; they contain: 

1- The name of the manufacturer. 

2- Exposure dangers ex. Carcinogen, irritant, teratogen, mutagen. 

3- Physical and chemical characteristics of the chemical. 

4- The physical hazards it possesses. 

5- Reactivity of the chemical. 

6- Precautions for safe handling. 

- Store the flammable chemicals (such as methanol) in safety cans or storage cabinet, 2 meters away from heat sources such as Bunsen burners. 

- Only store the working solution in the workbench for no more than 2 days. 

- Do not store chemicals that may cause reactions together. 

- If you use Irritant and toxic chemicals, must work in a well-ventilated area. 

- Use the appropriate PPE for that specific chemical you are handling. 

- Safety showers and eye drainage or washing corners must be constructed in the laboratory to solve the spillage of acid and alkali chemicals, and the procedures to be performed must be written in the form of stickers or documents. 

- Never hold chemical vials without their appropriate container. 

- When handling chemicals, do not wear contact lenses because it will be difficult to clean your eyes if an accident occurs.

- If the cable inserts are not manufactured correctly, electrical hazards may occur in the laboratory. 

- If there is no proper plastic cover, the socket and cable are faulty. 

- Handle the cable with wet hands. 

- Low-quality machines that failed the quality test. 

- Unstable current from the utility provider may damage the equipment or even cause a fire. 

- Fire could start in a laboratory because of electrical interaction with chemicals; for example, flammable chemicals must be stored away from direct flame and faulty electrical machines and wiring. 

- Due to excessive workload, the machine may start a fire in the laboratory due to overheating. 

- It is very important to use flames such as Bunsen burners in a safe environment. 

- The laboratory must be well ventilated. 

- Never smoke in the laboratory 

- Some chemicals are explosive even in a vapor state; Therefore, please read the manuals that come with them carefully and keep them properly 

- Most importantly, the laboratory’s infrastructure must be carefully planned and constructed to avoid fire hazards and must include existing emergencies, plans, and procedures (if they occur).

 

In general, we have mentioned the problems that may occur due to a variety of hazards, and how to manage these problems in the laboratory, to formulate these rules for medium-sized laboratories. 

However, in the case of advanced research laboratories, we can also include radiation hazards that may originate from radioactive materials. 

Medical waste is a special waste from health care facilities that if improperly treated it will lead to health problems. 

Generators of hazardous waste have a legal responsibility to protect both individuals and the environment when disposing of waste. 

Producers of medical waste must perform the following procedures: 

- Establish an infectious waste program. 

- All waste should be placed into labeled bags and containers. 

- The sharp instruments should be placed into special puncture-resistant containers. 

- Flushing down the drain to the sewer system such as water-soluble substance. 

- Incineration such as flammable materials. 

- Landfill burial such as solid chemical wastes. 

- Recycling such as solvents.