Risks of Pipetting to Laboratory Workers, Sample, Test, Patient and Final Data

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Risks of Pipetting to Laboratory Workers

Ergonomics of pipetting is important and relates to development of WRULD (Work Related Upper Limb Disorders, CTD (Cumulative Trauma Disorder) or RSI (Repetitive Strain Injury). These include a whole spectrum of diseases, from tendonitis of the hand or wrist to carpal tunnel syndrome. If hands or wrists hurt or go numb or tingle, if your joints ache after repetitive tasks, such as pipetting, it is almost certainly a WRULD. Other symptoms include losing strength or coordination in your hands, perhaps even dropping objects. Not everyone experiences all symptoms, and sometimes your symptoms may not occur until several hours or even days after the activity which causes them. This problem can be caused by a number of elements: Design of the pipette, number of repetitions, seating position, lack of rest intervals or poor bench layout. It can be also accompanied by other ailments such as backaches or headaches. Although this problem is not clearly covered in legislation, cases frequently come to light, employers naturally become very concerned and directives will no doubt follow in due course.  Secondly the action of pipetting can form aerosols. Obvious precautions need taking to avoid inhalation or even skin contact. All laboratories should have sound safety practices and these are governed by established bodies world-wide. Protective coats, gloves, laminar airflow cabinets etc. all assist in this prevention.

Courier-Delivered Specimen Transport Regulations

Specimens transported by a hospital courier among clinics, physicians’ offices, and the hospital laboratory are exempt from most U.S. Department of Transportation (DOT) rules unless they are suspected of containing an infectious substance. The transport vehicle should be used exclusively for transport of these materials and should be equipped to secure the transport containers.Minimum shipping standards for this type of transportation include:

The Standard Precautions in the Laboratory

Standard precautions is the combination of the major features of the Universal Precautions(UP) and Body Substance Isolation(BSI).It should be used for the care of patients and also for the protection of the healthcare workers. Standard precautions include the following:

Personal Protective Equipment (PPE)

Personal Protective Equipment(PPE)

Personal protective equipment encountered by laboratorians includes gloves, gowns or laboratory coats, masks, goggles, face shields, and Plexiglas countertop shields. Gloves are worn to protect the health-care worker’s hands from contamination by patient body substances and to protect the patient from possible microorganisms on the health-care worker’s hands. Wearing gloves is not a substitute for handwashing. Hands must always be washed when gloves are removed. A variety of gloves are available, including sterile and non-sterile, powdered and unpowdered, and latex and non-latex.

Proper Technique of Handwashing

Hand contact represents the number-one method of infection transmission. Hands should always be washed at the following times: before patient contact, when gloves are removed, prior to leaving the work area, whenever the hands have been knowingly contaminated, before going to designated break areas, and before and after using bathroom facilities. Correct routine handwashing technique includes the following:

The Body Substance Isolation (BSI)

Body substance isolation (BSI) is a  modification of universal precautions and is not limited to bloodborne pathogens and considers all body fluids and moist body substances to be potentially infectious. Personnel should wear gloves at all times when encountering moist body substances. Unlike UP(Universal precautions) , a disadvantage of the BSI guideline is that it does not recommend handwashing after removing gloves unless visual contamination is present. The practice of BSI was common in Pre-Hospital care and Emergency Medical Services due to the often unknown nature of the patient and his/her disease or medical conditions. It was a part of the National Standards Curriculum for Prehospital Providers and Firefighters. The features of UP and BSI have now been combined and are called “Standard Precautions”.

The Universal Precuations (UP)

Universal precautions (UP) were instituted by the CDC in 1985 to protect health-care workers from exposure to bloodborne pathogens, primarily hepatitis B virus (HBV) and HIV. Under universal precautions, all patients are assumed to be possible carriers of bloodborne pathogens. Transmission may occur by skin puncture from a contaminated sharp object or by passive contact through open skin lesions or mucous membranes. The guideline recommends wearing gloves when collecting or handling blood and body fluids contaminated with blood, wearing face shields when there is danger of blood splashing on mucous membranes, and disposing of all needles and sharp objects in puncture-resistant containers without recapping.