Labeling Bloodborne Pathogens
Written by Jack Rubinger
Beware of bloodborne pathogens. "Fortunately, all bloodborne pathogens including Hepatitis B, Hepatitis C, HIV and other infectious agents transmitted as BBPs can be prevented by use of PPE, engineering controls, work practice controls and strict compliance with safety standards," said Linda L. Williford, Ph.D.
One of the most critical applications in laboratories is BBPs which should be identified and labeled. The OSHA BBP standard is a federal law which requires employers and employees to follow certain precautions which contribute to infection control practices.
Also, OSHA requires labeling specimen containers used for storage, transport or shipping. Traditional paper biohazard labels typically cannot withstand temperature changes without damage. Using BS5609 certified (marine grade) vinyl labeling materials, which withstand temperature and moisture changes, is a better choice for this type of application.
Steve Halvorson, Assistant Laboratory Director, department of Molecular Virology and Biology at Baylor College of Medicine in Texas, conducts research for clinical studies involving patients and basic science. He tells his story about creating a safety labeling "culture" at his lab.
Steve trains laboratory staff to comply with the chemical labeling requirements for secondary containers containing common lab reagents. The graduate students in his department learn about the NFPA Diamond system and apply that knowledge in the laboratory setting.
Because he works with graduate students on the road from a Bachelor's Degree to a PhD, as well as newly arriving faculty, the natural turnover is high and there's a tremendous loss of institutional knowledge. This requires constant training in the requirements for NFPA labels on secondary containers because many times, clinicians and medical research staff sub-aliquot reagents from industrial bottles.
Label durability and clarity is important for laboratorians or researchers that move reagents through a variety of temperatures such as -80C to room temperature. The easier and more useful labeling becomes, the more likely it is to be implemented," said Dr. Perry Scanlon, Program Director, Associate Professor, Medical Laboratory Science Program, Department of Allied Health Sciences, Austin Peay State University.
Research labs are dynamic environments with continually changing activities and requirements. At times proper labeling is delayed, forgotten, or takes a back seat to other requirements.
In addition, laboratory staff may not be aware of various labeling materials and their suitability for different environments. For example, containers will sweat when moved from a cold environment to an ambient temperature location. This can result in labels being damaged, the printing smearing, or the label falling off. It is important to use label materials that will withstand moisture and temperature changes.
Clinical Lab Scientist Alicia D. Santos, M.S.M.T., handles the pre-analytic phase of specimen testing. Her lab labeling challenges are different from Halvorson's and are important to note.
"We handle specimens with barcode labels drawn by phlebotomists and nurses on the floor. We often see improperly placed barcode labels. The specimen barcode labels are placed in reversed positions, placed too high or too low on the tubes, wrapped around the tube so you cannot see the integrity of the specimen inside, or applied sloppily. All these will cause a barcode not being read or scanned tests will not be run causing delays in testing and patient care," she warned.
"A culture of safety must be strongly promoted in all research and clinical laboratories. After all, it is the law. I believe that both basic science and clinical research laboratories should adhere, without exception, to OSHA regulations concerning hazard labeling," said Williford.
Halvorson's group produces many chemicals and reagents in the lab, but often times they may not be fully aware that the hazard characteristics of a substance may need to be communicated to first responders. For example, a 1X PBS (Phosphate Buffered Saline) solution in a laboratory is recognized by most researchers as a non-hazardous reagent used to gently buffer cells. It seems silly to a researcher to place an NFPA label on a bottle of 1X PBS when plain water can be more hazardous to some cells.
Emergency responders may not know whether IX PBS is hazardous or benign. The NFPA label informs them that this is a substance they do not need to be concerned about. In the near future, the Globally Harmonized System of Chemical Classification (GHS) will use a common and consistent approach to labeling and classifying chemical hazards to ensure optimal environmental health and workplace safety across the world.
So what's the big takeaway? There's an ongoing need for education, training and review. Constant awareness about proper labeling assures safety within the laboratory environment.