Laboratory management and ethics

 

Unit II: 
A. Awareness and safety in a clinical laboratory, General safety precautions

IMPORTANT QUESTIONS:

1. Laboratory safety definition? Describe the classification of it.

Ans: Laboratory safety is a careful process, with the goal of preventing injuries and diseases from occurring among students, scientists, laboratory staff, and the community.

Classification:

a. Personal safety

b. Room and Environment safety

c. Reagent and equipment safety

2. Why laboratory safety is important?

Ans: Laboratory safety is a major aspect of every lab-based science class. To Prevent-

a. adverse health effects from exposure to chemicals

b. exposure to organisms, diseases, etc. in laboratories

c. laboratories equipment hazards- if not maintained properly

3. Short notes on:

a. Personal Protective Equipment [PPE]

=> Personal protective equipment (PPE) refers to clothing, equipment, or gear worn to minimize exposure to hazards or risks in the workplace or other environments. PPE includes items like masks, gloves, safety glasses, helmets, and protective clothing. Its purpose is to protect individuals from physical, chemical, biological, or other hazards, reducing the risk of injury or illness. Proper selection, use, and maintenance of PPE are essential for ensuring worker safety and health.

b. Room and Environment safety

=> Room and environment safety in laboratory management involves ensuring that the laboratory facilities and surroundings are designed, maintained, and operated to minimize risks to personnel, equipment, and the environment. This includes measures such as proper ventilation, storage of hazardous materials, emergency response protocols, and regular safety inspections. Effective room and environment safety practices promote a safe and healthy working environment, prevent accidents, and protect against environmental contamination.

c. Reagent and equipment safety

=> Reagent and equipment safety in laboratory management entails ensuring that chemicals, reagents, and equipment are handled, stored, and used safely to minimize risks to personnel and the environment. This involves proper labeling, storage, and disposal of hazardous materials, as well as regular maintenance and calibration of laboratory equipment. Adhering to safety protocols and providing adequate training to personnel are crucial for preventing accidents and promoting a safe working environment.

d. Biological safety levels [BSL]

=> Biological Safety Levels (BSL) classify laboratories based on the level of containment required when handling biological agents. They range from BSL-1 (lowest risk) to BSL-4 (highest risk). Each level has specific guidelines for facility design, equipment, and procedures to ensure the safety of personnel and prevent the release of pathogens into the environment. Compliance with BSL standards is essential for protecting laboratory workers, the public, and the environment from potential hazards associated with handling biological materials.

4. What are the Lab safety rules?

Ans: The Lab Safety rules are-

i. General behaviour

ii. Segregation of activities

iii. Proper use of symbols and warning signs

iv. Food and drink consumption and storage

v. Personal Protective Equipment [PPE]

vi. Clothing, footwear and hair

vii. Quality instruments with regular maintenance.

5. What are the steps in hazards exposure?

Ans:

i. Safety

ii. Fire

iii. Breakage of glassware

iv. Sharps

v. Spillages

vi. Pressure equipment & gas cylinders

vii. Extremes of heat & cold

viii. Chemical hazards

ix. Biological hazards

x. Radiation

6. Why do we need to have safety rules in the lab?

Ans:

i. Conducting laboratory experiments is a part of doing science to learn about nature and its laws.

ii. Laboratory experiments can involve materials and instruments that can hurt a scientist or a person next to him.

iii. To avoid possible accidents, we need to know the safe practices in the lab and follow those practices.

iv. It is everybody’s responsibility to follow the safety rules and procedures.

7. What are the general safety precautions?

Ans: The general safety precautions:

i. Wear appropriate personal protective equipment (PPE): This includes lab coats, gloves, safety goggles, and closed-toe shoes to protect against chemical spills, splashes, and other hazards.

ii. Follow standard operating procedures (SOPs): Adhere to established protocols for handling, storing, and disposing of chemicals, reagents, and biological materials to prevent accidents and contamination.

iii. Practice good hygiene: Wash hands thoroughly before and after working in the laboratory, and avoid eating, drinking, or applying cosmetics in lab areas to minimize the risk of exposure to hazardous substances.

iv. Maintain a clean and organized workspace: Keep laboratory benches, equipment, and storage areas tidy to reduce the risk of spills, accidents, and contamination.

v. Handle chemicals and biological materials with care: Use appropriate containment measures, such as fume hoods and biological safety cabinets, when working with hazardous substances to prevent exposure and release into the environment.

vi. Be aware of emergency procedures: Know the location of safety equipment, emergency exits, and emergency contact information, and be prepared to respond quickly in case of accidents, spills, or other emergencies.

vii. Communicate effectively: Clearly communicate with colleagues and supervisors about potential hazards, safety concerns, and emergency situations to ensure a safe working environment for everyone in the laboratory.

B. HIV: PRE- AND POST- EXPOSURE GUIDELINES:

1. What is called HIV?

Ans: Human immunodeficiency virus (HIV) is a retrovirus. Retroviruses are enveloped RNA viruses defined by their mechanism of replication via reverse transcription to produce DNA copies that integrate into the host cell's genome.

There are 2 HIV types, HIV-1 and HIV-2. HIV-1 causes most HIV infections worldwide, but HIV-2 causes a substantial proportion of infections in parts of West Africa. In some areas of West Africa, both viruses are prevalent and may coinfect patients. HIV-2 appears to be less virulent than HIV-1.

2. What are the pre and post exposure of HIV?

Ans: Pre-exposure prophylaxis (PrEP) involves taking antiretroviral medication before potential exposure to HIV to prevent infection. 

Post-exposure prophylaxis (PEP) involves taking antiretroviral medication after potential exposure to HIV to prevent infection.

C. HCV: PRE- AND POST- EXPOSURE GUIDELINES:

1. What is called HCV?

Ans: Hepatitis C is a viral infection that causes liver swelling, called inflammation. Hepatitis C can lead to serious liver damage. The hepatitis C virus (HCV) spreads through contact with blood that has the virus in it.

2. What are the pre and post exposure of HCV?

Ans: There is currently no pre-exposure prophylaxis (PrEP) available for HCV.

Post-exposure prophylaxis (PEP) for HCV involves administering antiviral medication after potential exposure to prevent infection.

D. HBV: PRE- AND POST- EXPOSURE GUIDELINES:

1. What is called HBV?

Ans: Hepatitis B is an infection of the liver caused by the hepatitis B virus. The infection can be acute (short and severe) or chronic (long term). Hepatitis B can cause a chronic infection and puts people at high risk of death from cirrhosis and liver cancer. It can spread through contact with infected body fluids like blood, saliva, vaginal fluids and semen. It can also be passed from a mother to her baby. Hepatitis B can be prevented with a safe and effective vaccine. The vaccine is usually given soon after birth with boosters a few weeks later. It offers nearly 100% protection against the virus.

2. What are the pre and post exposure of HBV?

Ans: Pre-exposure prophylaxis (PrEP) for HBV involves vaccination, which stimulates the immune system to produce antibodies against the virus before potential exposure.

Post-exposure prophylaxis (PEP) for HBV involves administering hepatitis B immune globulin (HBIG) and initiating the hepatitis B vaccine series after potential exposure to prevent infection.

E. DRUG RESISTANCE IN TUBERCULOSIS:

1. What is called TB?

Ans: Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.

2. How does drug-resistant TB develop?

Ans: Drug-resistant forms of TB can develop if treatment is incorrect or incomplete. This can happen for several reasons. Because treatment for TB takes six months and can have difficult side effects, people may be tempted to stop taking their medication before they have completed treatment, particularly if they are starting to feel better. They may be given the incorrect treatment or may fear the stigma of having TB. People with infectious drug-resistant TB can then also pass this drug-resistant strain on to others.

3. Explain the management of drug resistance in tuberculosis?

Ans: Management of drug resistance in tuberculosis involves several key strategies:

i. Drug susceptibility testing: Perform drug susceptibility testing to identify the specific drugs to which the TB bacteria are resistant.

ii. Individualized treatment regimen: Tailor the treatment regimen based on the drug susceptibility results, ensuring that the patient receives effective medications.

iii. Use of second-line drugs: If the TB bacteria are resistant to first-line drugs, prescribe appropriate second-line drugs based on susceptibility testing results.

iv. Directly observed therapy: Monitor treatment closely with directly observed therapy to ensure adherence and minimize the development of further drug resistance.

v. Adherence support: Provide support and education to patients to ensure adherence to the full course of treatment, which is crucial for successful outcomes and prevention of further resistance.

vi. Infection control measures: Implement infection control measures to prevent transmission of drug-resistant TB strains in healthcare settings and the community.

vii. Surveillance and monitoring: Continuously monitor drug resistance patterns and treatment outcomes to inform public health strategies and improve patient care.

F. PATIENT MANAGEMENT:

1. Short note on Clinical samples collection in TB patient

ANS: Clinical samples collection in TB patient:

sputum (expectorated): Three early morning specimens obtained on different days should be submitted. a volume of 5 to 10 ml is adequate and there is no advantage in collecting a larger volume. the sample should contain recently discharged material from the bronchial tree with minimal saliva content.

2. Short note on Transportation of TB patient

Ans: Avoid transport of an active TB patient if possible. If transport is necessary, the active TB patient must wear a surgical mask when leaving the room and healthcare workers who are transporting should consider using a respirator. An active TB patient must bypass the common waiting area.

3. Short note on Preservation of TB patient

Ans: In healthcare settings, the spread of TB is reduced through the use of protective masks, ventilation systems, keeping potentially infectious patients separate from other patients, and the regular screening of healthcare workers for TB.

G. ACCOUNTABILITY:

1. Define sample accountability.

Ans: Accountability is a key factor for quality assurance and laboratory safety in any scientific setting. It means that everyone in your lab is responsible for their actions, decisions, and results, and that they can communicate them clearly and honestly.

2. Explain purpose of accountability.

Ans: Accountability means showing up and setting out to accomplish the things you'd said you'd do. It's about taking personal responsibility for your work. It's also trusting in your teammates and knowing you can count on each other to get things done.

3. What are the different methods of accountability?

Ans: There are four main methods of accounting including.

• Documentary evidence

• Books of Accounts

• Financial Statements or reports

• Physical output or results