Yuck - according to this study, healthcare workers in English and Welsh hospitals who wear gloves are less likely to follow hand washing compliance measures. Fuller et al. (2011) found that "the rate of hand hygiene compliance was 41.1% with glove use, versus 50% without glove use" (Pal, 2011). In other words, glove use was strongly associated with lower occurances of hand washing. (Image Credit)
Fuller et al. posit that "healthcare workers may feel that wearing gloves not only protects them from the pathogens on patients but also protects patients from the pathogens on healthcare workers' hands and that this obviates the need for hand disinfection." Pal (2011) notes that "putting gloves on 'dirty hands' will lead to workers picking up, and possibly transferring, more pathogens, especially during high-risk contact."
Not complying with hand hygeine policies in a healthcare setting can lead to a dangerous work environment and a possible biosafety issue. Health and safety in the workplace - espeically workplaces that include patient care - can be a life or death situation.
"Wearing gloves can reduce transmission of organisms between workers and patients, but gloves are not a substitute for hand hygiene...Hands should be cleaned before the gloves are put on and then immediately after they are removed, according to World Health Organization (WHO) guidelines" (Pal, 2011).
The Mayo Clinic provides detailed instructions on proper handwashing:
"It's generally best to wash your hands with soap and water. Follow these simple steps:
- Wet your hands with running water.
- Apply liquid, bar or powder soap.
- Lather well.
- Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
- Rinse well.
- Dry your hands with a clean or disposable towel or air dryer.
- If possible, use your towel to turn off the faucet."
Two of our guys are off to ABSA 2011 this week, so it seems like a fine time to talk biosafety. Biosafety (or biological safety) can mean a lot of things to a lot of people, but a good general definition is: "the collection of handling and containment procedures, guidelines, and precautions that protect humans and the environment from exposure to biohazardous agents or materials" (UC Davis, 2011). The CDC provides the standard guide for biosafety, the "Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition" (CDC, 2010). From this document, laboratories and institutions take their guidance for all biosafety-related actions.
Personal Protective Equipment
Personal protective equipment (PPE) encompasses "the respiratory equipment, garments, and barrier materials used to protect rescuers and medical personnel from exposure to biological, chemical, and radioactive hazards" (WebMD, 2011). "OSHA requires the use of personal protective equipment (PPE) to reduce employee exposure to hazards when engineering and administrative controls are not feasible or effective in reducing these exposures to acceptable levels" (OSHA, 2011). If an institution needs to use PPE, there must be a PPE program that addresses: "the hazards present; the selection, maintenance, and use of PPE; the training of employees; and monitoring of the program to ensure its ongoing effectiveness" (OSHA, 2011).
Material Safety Data Sheets
Material Safety Data Sheets (MSDS) are "designed to provide both workers and emergency personnel with the proper procedures for handling or working with a particular substance. MSDS's include information such as physical data (melting point, boiling point, flash point etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill/leak procedures" (ILPI, 2008). MSDSs are used by:
- "Employees who may be occupationally exposed to a hazard at work.
- Employers who need to know the proper methods for storage etc.
- Emergency responders such as fire fighters, hazardous material crews, emergency medical technicians, and emergency room personnel" (ILPI, 2008)
While your institution is likely to have someone in charge of MSDSs, you can take a look at some online. McMaster University (2011) provides an excellent list of MSDSs on their website. The Canadian version of MSDS, Pathogen Data Safety Sheets can be found on the Public Health Agency of Canada's website. (Image credit)
Laboratory Biosafety Levels
Depending on the type of work being done in a lab, it will have a certain biological safety level (BSL) associated with it. These BSLs are determined by the biological agents and their risk levels, assuming that there are ordinary research circumstances in the laboratory. The BSLs are ranked 1-4, from low to high risk.
- BSL-1: The biological agents pose low risk to personnel and the environment. "These agents are highly unlikely to cause disease in healthy laboratory workers, animals or plants"
- BSL-2: The biological agents pose moderate risk to personnel and the environment. "If exposure occurs in a laboratory situation, the risk of spread is limited and it rarely would cause infection that would lead to serious disease. Effective treatment and preventive measures are available in the event that an infection occurs"
- BSL-3: The biological agents usually cause serious disease in humans, animals, or plants or can result in serious economic consequences
- BSL-4: The biological agents "usually produce very serious disease (human, animal or plant) that is often untreatable. These agents are usually easily transmitted from one individual to another, from animal to human or vice-versa, either directly or indirectly, or by casual contact" (Ohio State, 2011)
The BSL will determine the procedure for having research approved, the training required, and the PPE worn.
Throughout 2011, ABSA has actively supported the the Elizabeth R. Griffin Research Foundation's concept: "2011 – The Year of Building International Biosafety Communities." Their collaborative purpose is to "promote [worldwide] biosafety/biosecurity awareness, encourage the development of new local biosafety associations, promote the growth and sustainability of existing biosafety associations, increase the quality and participation in biosafety/biosecurity training, develop effective collaborative relationships amongst partners in the biosafety/biosecurity community, foster a greater sense of community amongst biosafety professionals worldwide, and initiate activities that will promote increased knowledge of biosafety and biosecurity to audiences within and outside the scientific research community" (ABSA, 2011). Along those lines, HealthRx has partnered with the National Institutes of Health, the World Health Organization, the Asia-Pacific Biosafety Association, and the National Biosafety and Biocontainment Training Program to host the Asia-Pacific Biosafety Training Network. We are also pleased to provided licensed versions of the APBTN's training courses within our Training Manager product.
Some other good sources from biosafety training and education can be found at the following links:
The CITI Program training for a solid foundation in the principles of the containment of biohazards
Laboratory biosecurity training from the CDC
Biosafety training from the CDC
ABSA's biosafety training tools
Definitions of biosafety terms
ABSA's alliance with OSHA
ABSA's Journal of the American Biological Safety Association
Hello, world. I'm Eric, HealthRx Technical Lead. Everyone once in a while we technical people get to see the Day Star and venture out in public. This time, it was to attend the first annual NIH Safety Day. Kelly and I got there bright 'n' early to set up our mini exhibit. Here's a picture of the "low maintenance" HealthRx display, complete with me playing on my two iPads:
We were happy to see that our brand new HealthRx syringe pens were a hit with the exhibit visitors!
The theme of the day was "Safe Science and Good Science Go Hand-in-Hand," a statement that we at HealthRx believe whole-heartedly in. Dr. Gottesman, Deputy Director for Intramural Research, began the day by telling us about the Irving Caesar safety songs he learned as a child. Even as children, we're taught to make safety an integral part of everything we do, but sometimes we forget those lessons when we're busy adults. Keynote speaker Jim Welch, Executive Director of the Elizabeth R. Griffen Research Foundation, spoke about the impact of not taking the time for safety precautions when working in a lab. Elizabeth Griffen, the namesake of the foundation, died of an eye exposure when working with macaques without wearing goggles. Her needless death was a reminder to the audience that people never get hurt from being too safe.
The first annual NIH Safety Day was an overwhelming success, and we sincerely thank the NIH Department of Occupational Health and Safety for hosting us so nicely. We really enjoyed getting to see many of our customers and chatting with them at our booth. The NIH is incredibly important to us, so it's always nice to be able to get out and see the people we serve, face-to-face. As a technical person, I don't tend to be able to connect lines of code with the bigger picture of enterprise biosafety. Being able to attend Safety Day was a real eye-opener for me, since I could see firsthand what an important role HealthRx gets to play in keeping researchers and employees at the NIH safe.
From high school science labs to the largest biomedical research institutions, laboratory safety is of critical importance to not only the researchers' well being, but to the integrity of the experiments. I asked the HealthRx staff to contribute their favorite bookmarked lab safety websites so we could share them with you.
Laboratory Safety institute (LSI)
OSHA Laboratory Safety
Decontamination and Sterilization
UCR Environmental Health & Safety Program
University of Oregon Environmental Health & Safety
UVM Environmental Safety
UW Office of Safety and Loss Prevention
Southern Illinois University Carbondale Center for Environmental Health and Safety (CEHS)
Notre Dame Laboratory Safety
LSI Safety and Related Acronym List
LSI Safety FAQs
Duke Occupational & Environmental Safety Office
NIU Laboratory Safety Guidelines
UVA Environmental Health & Safety (EHS)
The NIOSH Pocket Guide to Chemical Hazards
Prudent Practices in the Laboratory: Handling and Disposal of Chemicals (1995)
Flinn Scientific General Laboratory Safety
Flinn Scientific Laboratory Chemical Safety
Flinn Scientific Eye and Eyewear Safety
Flinn Scientific Laboratory Safety Courses
You can find more resources on our Community Resources page. There, you can find resources for general workplace safety, biosafety, select agents, general research, occupational medicine, health sciences organizations, medical reference, and industry news. These are updated on a regular basis, so check back frequently. If you have any suggestions for great lab safety or other health sciences resources, please leave them in the comments.
Medical surveillance is an occupational health and safety practice used in biomedical and clinical research facilities to track employee compliance for receiving the necessary medical attention (e.g., vaccines, tests, serum samples) for the materials they are working with. Electronic medical surveillance programs are automated systems that could be thought of as specialized EMRs that contain the necessary information for protecting the researcher while he or she is at work.
An individual's medical surveillance record would include research materials, animals, and equipment he is working with at a minimum. For example, if Principal Investigator Dr. Morgan is working with HIV, monkeys, and needles, it would be important to have a system that can automate regular HIV testing and can be able to handle recording Dr. Morgan's treatment when she is bitten by a monkey, gets the monkey's HIV-positive blood in her eye, or gets stuck with an infected needle. Bottom line, electronic medical surveillance allows occupational health care providers to enforce researcher compliance with preventative measures and to be prepared for worst case scenarios, like monkey bites.
Medical surveillance could certainly be done in a paper-based system, but it would be more difficult to confidently track surveillance programs and ensure biosafety. Electronic medical surveillance allows automation, quicker recall, and off-site access. Another benefit of an electronic system is that it can be connected to other systems in the institution, such as clinic scheduling and management, research protocol submission/approval, and accident reporting systems, which could be the institution's legacy systems, a collection of systems from multiple third parties, or from a third party's integrative product suite.
To illustrate, our Electronic Medical Surveillance Manager (EMSM) is installed in Occupational Medical Services (OMS) at the NIH. They have chosen to connect the EMSM to other HealthRx systems in use at the NIH. The NIH's workflow is rather impressive with the number of researchers and newly registered research that happens at the different facilities. Everything begins with a researcher being proposed on a new research registration or added to an existing registration in PI-Dashboard, our research protocol submission/approval system. Once the research is approved, OMS receives a notification and the researcher is added to the appropriate medical surveillance programs in the EMSM. The EMSM connects to the Clinical Access Manager, allowing OMS to view the researcher's medical and visit history and to schedule surveillance program-related appointments. Any unfortunate issues that may lead to occupational injury or illness are recorded in both our accident reporting system, the Workplace Injury & Illness Manager, and in the EMSM. This process would be similar in other institutions and with other products/systems.
As one can see, using electronic medical surveillance, as opposed to a paper-based system, allows for more flexibility, better biosafety practices, and much easier processes for occupational medical staff. With the industry's and the Federal Government's push to move to electronic systems, electronic medical surveillance isn't just for future consideration, it's important for research and occupational healthcare now.
The 2011-2012 flu season kicks off in late Fall, but now is the time to begin to plan your battle against the flu in your hospital or research facility. The best way for you and those in your institution to avoid getting the flu is to be vaccinated. You can further prevent getting sick by:
- Washing your hands often with soap and water;
- Avoiding touching your eyes, nose or mouth; and
- Trying to avoid close contact with those who have the flu (which may be unavoidable for some healthcare providers) (HHS, 2011).
Why get vaccinated? The seasonal flu vaccine also prevents H1N1, and getting the vaccine can reduce a healthy adult's chances of getting the flu by 70-90%! While the general public should be vaccinated, it is especially important for researchers and healthcare providers to get the vaccine. According to the NIH, "several studies have shown that vaccinating healthcare workers reduces influenza complications and influenza-associated mortality in patients" (NIH, 2011).
Symptoms of influenza include:
- Coughing and/or sore throat
- Runny or stuffy nose
- Headaches and/or body aches
- Vomiting and diarrhea (HHS, 2011)
Those with flu symptoms should see a doctor. If your doctor diagnoses you with the flu, should stay home and away from others, follow your doctor’s orders, and watch for signs that you need immediate medical attention. In addition,
- Regularly wash your hands with soap and water or an alcohol-based hand rub;
- Cover coughs and sneezes;
- Drink plenty of clear fluids; and
- Get lots of rest (HHS, 2011).
HHS provides a wealth of great resources
for getting the word out about flu prevention in your institution. This website includes posters, flyers, brochures, letters, videos, podcasts, public service announcements, blogs, widgets, and eCards free for your use.
An excellent example of a workplace influenza prevention program is the NIH's "Foil the Flu." This program targets health care providers, physicians, and all other NIH employees and contractors in an effort to keep the flu away from their facilities. We have partnered with the NIH for the past three years to automate their vaccination tracking with our online Vaccination Manager. Last year, we introduced an iPad version as well that not only made Occupational Medical Services staff look pretty cool, but also allowed them to be even faster with processing people through their "virtual turnstile."
Whether a research or health sciences institution is on the cutting edge of technology, like the NIH, or has a smaller-scale effort, flu vaccination is key to keeping employees and patients healthy, and research and caregiving moving forward.
We are always scouring the internet and prodding our customers to get the best and latest biosafety resources. The internet is full of wonderful information, yet it is time consuming to dig through it to find what is useful to you. In an attempt to get you started and save you a little time, here are some of our favorite online biosafety resources:
Institutional Biosafety Committees (OBA Resources)
NIH Office of Biotechnology Activities (OBA)
Biosafety in Microbiological and Biomedical Laboratories (BMBL)
CDC Biosafety Training Courses
WHO International Health Regulations (IHR)
CDC Biological Risk Assessment Worksheet
Applied Biosafety, the Journal of the American Biological Safety Association (ABSA)
American Biological Safety Association (ABSA) Training Tools
CDC Guidelines for Laboratory Biosafety Competency
International Federation of Biosafety Associations
Public Health Agency of Canada Laboratory Biosafety Guidelines
EPA Hazardous Wastes Guidance
Public Health Agency of Canada Pathogen Safety Data Sheets (PSDSs)
MSDS Links from McMaster University
If you like these, you can find more resources on our Community Resources page. There, you can find resources for general workplace safety, laboratory safety, select agents, general research, occupational medicine, health sciences organizations, medical reference, and industry news. We freshen these up on a regular basis, so check back frequently. If you have any suggestions for great biosafety or other health sciences resources, please leave them in the comments.