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THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
PROCEDURE NO:
MOD:
Page:
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
1.
GDP 010
1st Issue
1 of 6
Purpose:
1.1
To list the legal requirements and University Policies pertaining to the
handling of Clinical Specimens in the laboratory.
1.2
To outline the guidelines and recommendations for working safely with
clinical specimens.
2.
Equipment:
2.1
3.
N/A
Materials:
3.1
The University of Newcastle Infection Control Policy with Reference to
HIV/AIDS, Hepatitis B/C and other Blood/Body Fluid Transmitted
Pathogens. 1993 (in the Medical Biochemistry Reference Folder, LS3-26).
4.
3.2
CCH Laboratory Safety Manual (in LS3-26)
3.3
Australian Standards, see Resource Manager.
Set Up:
4.1
All blood, blood products, body fluids and associated materials should be
regarded as infectious and handled with the same precautions used when
handling samples that are known to be infected with blood borne pathogens.
This is known as the principle of Universal Precautions.
4.2
Human blood and body fluids must only be handled in a PC2 lab or higher.
They must not be used in PC1 labs.
4.3
Blood or other human fluids must not be obtained from other staff members.
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DATE
Distributed To:
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AUTHORISED BY
THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
4.4
PROCEDURE NO:
MOD:
Page:
GDP 010
1st Issue
2 of 6
Researchers who wish to conduct research involving human participants,
human tissue or personally identifiable records must apply to the Human
Research Ethics Committee for ethical clearance prior to the research
commencing.
5.
Safety Precautions:
5.1
Read 'The University of Newcastle Infection Control Policy with Reference to
HIV/AIDS, Hepatitis B/C and other Blood/Body Fluid Transmitted
Pathogens' - appendix F; Infection Control Policy Guidelines Faculty of
Medicine.
5.2
The majority of laboratory acquired infections are caused by inhalation of
aerosols and by percutaneous absorption. Practical measures to be followed
when handling clinical specimens include:
♦ Wear laboratory coats when working with all biological specimens.
Remove laboratory coats before leaving the laboratory.
♦ Wash hands with anti-microbial soap following the completion of
laboratory activities, the removal of protective clothing, and before leaving
the laboratory.
♦ Use mechanical pipettors when working with liquids. DO NOT pipette by
mouth.
♦ Always wear gloves (preferably nitrile gloves, as they ranked above latex
gloves for protection against microorganisms) when dealing with
specimens and related contaminated surfaces.
♦ Wear safety glasses or a face shield to prevent splashes to the eyes and
face.
♦ Cover all cuts or legions on the hands with waterproof dressing.
♦ If possible, avoid the use of syringes and needles. Skin puncture injuries
are the number one cause of blood-borne disease transmission in health
institutions.
♦ All sharp instruments should be treated with extreme caution. Ensure that
they are disposed of or stored correctly.
♦ Do not re-sheath needles after use. Always dispose of them in the Sharps
waste bins provided.
♦ Use biological safety cabinets and other primary safety devices (for
example, centrifuge bucket lids) whenever there is a risk of aerosols being
THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
PROCEDURE NO:
MOD:
Page:
GDP 010
1st Issue
3 of 6
created. Centrifuging, blending, sonicating, vigorous mixing and
harvesting tissue from animals all generate aerosols. Use a sealed
centrifuge for spinning clinical samples. Ensure that the rotor has stopped
spinning completely before opening the centrifuge. Use bucket lids when
spinning and remove the entire bucket and open it in the biological safety
cabinet (if the centrifuge design permits). If a tube has broken inside the
centrifuge the whole bucket should be autoclaved (if possible).
♦ Decontaminate laboratory work surfaces with a disinfectant after
completion of work. Use 70% alcohol to wipe down corrodible equipment.
♦ Decontaminate all clinical waste and associated materials before disposal
or reusing.
5.3
As stated in the University of Newcastle Infection Control Policy with Reference to
HIV/AIDS, Hepatitis B/C and other Blood/Body Fluid Transmitted Pathogens, it is
recommended that researchers dealing with blood, blood products and body
fluids be immunised against Hepatitis B. Some researches may also consider
being immunised against other pathogens, depending on what they are
exposed too and whether inoculations are safe and effective.
5.4
The following steps should be taken in the event of a worker becoming
exposed to blood, blood products and other body fluids by way of a needle
stick injury or cut:
♦ Encourage bleeding and wash the cut/puncture liberally with soap and
water or with a dilute hyperchlorate solution (0.5%).
♦ If the face is splashed, wash the eyes and mouth with water.
♦ Fill in an accident form and report the incident to the supervisor.
♦ If the HIV status of the source material involved in the accident is
unknown, permission to test it for HIV must be obtained. A test for HIV
antibody on the workers' blood sample must be performed as soon as
possible.
NB
For further details on procedure and legal problems associated with
injuries see The University of Newcastle Infection Control Policy with
Reference to HIV/AIDS, Hepatitis B/C and other Blood/Body Fluid
Transmitted Pathogens, Appendix N.
THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
PROCEDURE NO:
MOD:
Page:
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
5.5
GDP 010
1st Issue
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DISINFECTANTS
Some disinfectants are more appropriate than others for specific
microorganisms. Vegetative forms of most bacteria and lipid-containing
viruses are readily susceptible. Fungi, acid-fast bacteria and most non-lipid
containing viruses are less susceptible, while bacterial spores are resistant to
most disinfectants. Before using any disinfectant, refer to its MSDS and ensure
that the correct personal protective equipment is worn.
5.5.1
CHLORINE (Sodium Hyperchlorite/other chlorine releasing agents)
Sodium hyperchlorite has been recommended as an effective
disinfectant against hepatitis B and HIV, however it is less effective
against spores. (Hyperchlorate solutions are most effective when
freshly made).
Soiled Surface/Item
Concentration of sodium hyperchlorite
grossly soiled with blood or body fluids
0.5% (500 ppm) available chlorine
porous surfaces, benches, floors, walls (not
0.05% (5000 ppm) available chlorine
visibly soiled but likely to be contaminated)
NOTE : As chlorine combines with proteins, the concentration of chlorine needs to be increased to overcome this
organic demand. For example, an equal volume of 5000 - 10 000ppm (0.5 - 1%) available chlorine is required for
the inactivation of HIV or hepatitis in blood or serum.
Stabilized sodium hyperchlorite solutions retain an effective chlorine
level longer than other chlorine solutions. For biocidal action, the
solution must be between 6 and 8 pH.
For decontamination, leave the hyperchlorite solution in contact with
the contaminated area for 10 minutes. Soak up all fluids and dispose of
into a contaminated waste bag. Wipe the surface again with a fresh
application of hyperchlorite solution, then clean the area with
detergent and water.
♦ Hyperchlorite solutions may be corrosive for metal instruments
♦ Gloves must be worn when handling hyperchlorite solutions
♦ If possible, maximise the ventilation in an area where hyperchlorite
is being used
♦ Never use hyperchlorite solutions in aerosol (spray) form as it has
been proven to cause serious problems as a result of fume
inhalation.
THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
5.5.2
PROCEDURE NO:
MOD:
Page:
GDP 010
1st Issue
5 of 6
ETHANOL
70% Alcohol solutions are an effective agent for decontamination of
clean surfaces or the skin. Alcohols are unsuitable for use on
proteinaceous substances as they tend to coagulate and precipitate
surface proteins which may result in the protection of microorganisms
present.
Solutions of Alcohol (70% v/v) used to disinfect contaminated material
should remain in contact with the material for at least 20 minutes. It is
a suitable disinfectant for use against a wide range of vegetative
bacteria and lipid-containing viruses. Alcohols are ineffective against
spores.
♦ 70% alcohol should not be relied upon to disinfect surfaces
contaminated with hepatitis.
♦ Ethanol is suitable for use on porous surfaces due to its volatility,
however, repeated applications may be necessary to ensure a
thorough coverage.
♦ Ethanol must be used cautiously near electrical appliances and
naked flames due to its flammability
5.5.3
IODINE
Iodine in aqueous or alcoholic solutions (0.5% iodine in 70% alcohol) is
effective against a broad spectrum of bacteria and some spores. It does,
however, stain the skin and may have irritating or sensitizing effects.
The pH of iodine must be between acid to neutral for best performance.
This disinfectant must be left in contact with the contaminated material
for at least 20 minutes.
5.5.4
For further information on disinfectant types and uses see the
Australian Standard - Safety In Laboratories Part 3: Microbiology
(AS/NZS 2243.3: 1995).
6.
Maintenance:
7.
Shutdown:
7.1
N/A
If you were required to read this GDP, sign the Requested Reading Record
Sheet (Illustration 5.2) of GDP 001 Induction Procedure.
THE UNIVERSITY OF NEWCASTLE - DISCIPLINE OF MEDICAL BIOCHEMISTRY
STANDARD OPERATING PROCEDURE
Procedure Type:
General Discipline Procedure
Title:
Clinical Specimen Safety
8.
Illustrations:
9.
Check List:
9.1
10.
PROCEDURE NO:
MOD:
Page:
GDP 010
1st Issue
6 of 6
N/A
Necessary records completed.
References:
10.1
CCH Laboratory Safety Manual
10.2
Australian Standard - Safety In Laboratories Part 3: Microbiology (AS/NZS
2243.3: 1995).
10.3
The University of Newcastle Infection Control Policy with Reference to
HIV/AIDS, Hepatitis B/C and other Blood/Body Fluid Transmitted
Pathogens (1993).
11.
Change History:
11.1
Issue Number:
Date Issued:
11.2
Issue Number:
Date Issued:
1st Issue