Transcript Hazard Communication/Right to Know

Hazard Communication/
Right-to-Know
for MSO, Medical Students and Nursing Students
Environmental Health & Safety
4-6783
www.stonybrook.edu/ehs/healthcare
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Training Outline
1. Hospital Safety Information
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Environment of Care
Respiratory Protection
Injury/Illness Reporting
Reducing SB Medicine Staff Exposures
Contaminated Sharps Injuries
Formaldehyde (Formalin) Safety
Glutaraldehyde/OPA Safety
Hazardous Drugs (HD) Safety - New
Ethylene Oxide (EtO) Safety - New
Waste Anesthetic Gases (WAG) Safety - New
Ergonomics Policy
Environmental Awareness
Transporting Infectious and Diagnostic Specimens
2. Hazard Communication/Right to Know
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Environment of Care (EOC)
Management Plans:
• Each reference card has
critical information
• Posted in all patient care
areas
• Please review; you are
responsible for knowing
information on cards
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Top 12 Ways to Insure EOC
Compliance
1. Always wear your Stony Brook ID badge.
2. Know proper procedure for Major Chemical
Spill response.
– Call University Police at 911 or 631-632-3333
from cell phone. (Off sites call 911)
3. Know the location of your department’s
Emergency Management Manual and Plan.
4. Know location of your unit’s disaster kit for
power outages (flashlights, batteries,
extension cord, duct tape, glow sticks).
5. Know how to shut off the oxygen supply valve.
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Top 12 Ways to Insure EOC
Compliance
6. Report building issues to Plant Operations at
4-2400.
7. Know proper fire response procedures (RACE).
8. Know locations of nearest fire alarm pull
stations and how to use a fire extinguisher
(PASS).
9. Secure your personal belongings.
10. Know how to access Safety Data Sheets, SDS,
on-line (formerly referred to as MSDS).
11. Adhere to no smoking policy.
12. Report building related issues. (Tech Park:
Contact Facilities Manager, 4-4380)
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Respiratory Protection
• SBUH requires all hospital employees,
who come in contact with patients with
known or suspect TB or another
airborne pathogens, be annually fitted
with a hospital approved N95 respirator.
• If you experience significant weight gain
or loss, dental or facial surgery, or other
condition that may affect respirator fit,
you must be re-fitted, even if it is within
a year of your last fit test.
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N95 Respirator- User Instructions
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Prior to wearing a respirator you must be medically cleared
by Employee Health, and trained/fit tested by EH&S.
Only wear the Type, Make, Model and Size respirator you
were fitted with (e.g., N95, 3M 1860S). Keep fit test card
with respirator information in your ID badge.
Read user instructions.
Inspect your respirator and conduct the User Seal Check
prior to each use.
Before you enter an isolation room that requires a
respirator, put on your respirator in the corridor (not in the
ante-room or patient room).
For TB exposure, discard the N95 respirator when soiled
or damaged. For SARS or smallpox exposure, discard
after each use, unless directed otherwise.
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N95 - No Interfering Facial Hair
• Anyone with interfering facial
hair cannot be fit tested or wear
a N95 respirator because it
prevents a good seal around the
face.
• A small goatee or mustache that
fits inside the respirator may be
OK, but a full beard or
substantial “stubble” is not.
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N95 Respirators
Do I need to Wear a Surgical Mask over the N95 Respirator?
Typically no.
The hospital approved N95 respirators (3M 1860
and the Moldex/Inovel 1500 series) are both
rated as surgical masks.
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N95 Annual Respirator
Fit Testing
For Residents: Fit testing will take place the
day of Orientation. (If you are not able to get fit tested at
Orientation, you can be fit tested at one of the open monthly sessions).
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Open monthly fit testing schedule is provided
in the Hospital weekly announcements and
on the Hospital’s intranet under “Hot Topics”.
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Injury/Illness Reporting
 Report any work related injury/illness to your
supervisor.
 If necessary, seek medical attention at
Employee Health and Wellness. If life
threatening or off hours, go to the ED.
 Complete an Employee Injury/Illness Report
and fax to 2-2687.
 Contact the Accident Reporting System (ARS)
at 888-800-0029.
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Contaminated Sharps Injuries
How can we prevent future injuries?
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Reducing Contaminated
Sharps Injuries
 Use a device with a safety, if available.
 If you are unsure how to use a device, seek
guidance.
 Actively participate in trials of new safety devices.
 Limit distractions and conversations -- Don't
disturb a colleague while they are using a sharp.
 Avoid multiple attempts during phlebotomy, ABGs,
IV catheter insertions, CV catheter placement, and
lumbar punctures.
 Use blunt tip needles in OR.
 Use extreme care when suturing.
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Reducing Contaminated
Sharps Injuries
 Take your time, don't rush.
 "Cool off" after interpersonal conflict.
 Avoid passing.
 Immediately discard used sharp in sharps
container.
 When a sharps containers is ¾ full, have
someone contact Hospital Custodial Services at
4-1455. (Off-sites: call Bob Weniger at 4-4066).
 Report all injuries and complete an Employee
Injury/Illness Report and Sharps Injury Log.
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Formaldehyde/Formalin Safety
-human carcinogen-
When using specimen
containers with formalin:
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Minimize length of time
containers are open
Avoid spillage
Clean up any spillage
immediately
Wear PPE – nitrile gloves
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Glutaraldehyde and
Cidex OPA Safety
Glutaraldehyde and Cidex OPA –
eye, skin, respiratory tract irritant
How to minimize exposure:
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Use appropriate ventilation: GUS
Wear PPE (gloves, gown and eye
protection).
Pour carefully.
Keep containers closed when not in
use.
Use Glute-out neutralizer prior to drain
disposal and for spills.
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Hazardous Drugs (HD) Safety
Glutaraldehyde and Cidex OPA –
• Look for “HD Precautions” sign on in-patient
eye, skin, respiratory tract irritant
room doors
• Wear appropriate PPE
 Anticipation of hand exposure – wear double nitrile
gloves, change out after 30 minutes
 For chemo and for anticipation of body splash –
wear chemo gown
• Avoid crushing or cutting HD tablets
• Review HD Management policy, EC:0048
Hazardous Drug - as defined by NIOSH (National Institute of Occupational Health & Safety), any drug
identified by at least 1 of the following 6 criteria: carcinogenicity, teratogenicity or other developmental
toxicity, reproductive toxicity in humans, organ toxicity at low doses in humans or animals, genotoxicity, or
new drugs that mimic existing HDs in structure or toxicity. Include drugs for cancer chemotherapy, antiviral
drugs, hormones, some bioengineered drugs and other miscellaneous drugs and are identified on
NIOSH’s List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings.
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Ethylene Oxide (EtO) Safety
• EtO is a flammable, colorless gas
used to sterilize surgical equipment
• Central Sterile Supply (CSS) uses
EtO in closed system sterilizers/
aerators
• 2 EtO abators works automatically
and interface with sterilizer/aerators
• CSS has gas alarm system with
master alarm panel outside EtO
room with visual and audible alarms
– 3 separate EtO monitors, in EtO Room
and by each abator
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Waste Anesthetic Gases (WAG)
Safety
• WAG = nitrous oxide and halogenated anesthetics
(e.g., halothane, enflurane, isoflurane, desflurane).
– exposure from leakage of patient's anesthetic breathing
circuit during delivery of anesthetic and exhalations of
patients recovering from anesthesia
• Use anesthesia delivery units with gas scavenging as per
manufacturer’s instructions.
• Face masks used for administrating inhaled anesthetics
should be available in variety of sizes, pliable, provide
effective seal to prevent leakage, and positioned on the
patient’s face properly.
• Wear PPE during spills of liquid anesthetic agents (gloves,
goggles, face shields)
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Ergonomics Policy
Ergonomics:
EH&S is responsible for managing the
Ergonomics Program, in consultation
with Employee Health & Wellness
science of human work focusing on designing work
stations, tools & tasks for safety, efficiency & comfort.
Musculoskeletal Disorders: (SDS) result from bodily
reactions due to bending, climbing, crawling, reaching,
twisting, overexertion, or repetitive motion. Injuries can
occur to muscles, nerves, tendons, ligaments, joints,
cartilage, and spinal discs in back, neck shoulder, elbow,
wrist or hand.
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Ergonomics Policy
Reporting: Employees need to report work related
injuries to their supervisor.
Incident Trending: when a trend of MSD injuries is
identified in an area, a hazard assessment will be
conducted.
Response: Controls may be used to reduce
hazards
Training: General ergonomics awareness will be
provided by EH&S during Orientation,
recertification classes and online.
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Environmental Awareness
What happens to waste
that is poured down the
drain?
It goes to the Sewage
Treatment Plant at
the University and
then into the Long
Island Sound.
Sewage
Treatment Plant
at the University
Remember: Do not put any
hazardous waste down the drain.
Long Island Sound
Port Jefferson, NY
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What is Chemical
Hazardous Waste?
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Chemical hazardous waste can include
medications, cleaning products, paints, solvents,
acids/bases.
Most hazardous wastes have been identified
throughout the Hospital and are being collected.
If you are unsure whether you are generating a
hazardous waste or are disposing of a new
chemical product, complete a Waste Determination
(Admin P&P EC:0045).
If you have any questions, contact EH&S at 4-6783.
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Common Chemical
Waste Containers
You might see the following 4 waste disposal containers
on the units:
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Pharmacy Return Box – all unused or
expired drugs
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Black 2-gallon container – Partially Used
Drugs with a HW label.
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Locked Box (Critical Care areas) –
Epinephrine, Propofol (Diprivan),
Eptifibatide (Integrilin) and Nitroglycerin
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Chemo container (Oncology areas) –
Chemotherapy waste.
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HW
Regulated Medical Waste
(Red Bag Waste)
• Place the following in Red
Bags:
• All waste generated in
diagnosis, treatment or
immunization of humans:
• Cultures and stocks
• Human pathological
waste excluding teeth
• Human blood and
blood products
• Waste products must be
“saturated” with blood or
bodily fluids so that when
squeezed produces free
flowing fluid or flecks
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Sharps Waste
Place in Sharps Containers:
• Needles
• All Syringes with needles
• Syringes without needles that
have come in contact with
blood or body fluids
• Pipettes
• Slides and cover slips
• Scalpel blades
• Glass test tubes
• Disposable staples
• Explanted orthopedic
hardware
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Transporting Infectious
Substances
• All Infectious substances must be packed and
shipped by specially trained employees.
• Hazardous materials MUST be properly labeled
and packed for shipment.
• Training for shipping infectious substances and
other hazardous materials is required and
available from EH&S (4-6783).
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Hazard Communication/RTK OSHA & PESH
OSHA
Occupational Safety &
Health Administration
Oversees Hazard
Communication
Standard in the private
sector
PESH
Public Employees
Safety & Health Bureau
Oversees Hazard
Communication (RTK)
Standard for public
employees at the state
and local level
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Required Departmental
Postings
Employers must
post a sign in
every workplace
to inform
employees that
they have a right
to hazard
information.
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Employer Responsibilities
• Notify you about your
right to request
information
• Provide information
within 72 hours
• Maintain information
• Provide education and
training
• Maintain records on
exposures
• Maintain labeling
system
• Provide hazard
information to nonemployees
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Employee Rights
• Submit written requests for
information
• Refuse to work with a toxic
substance if no reply
received within 72 hours
• Obtain access to University’s
written Hazard
Communication, Right to
Know program
• Can not be forced to waive
any rights under the Law as
a condition of employment
• Can file complaints with
Department of Labor or
NYS Attorney General
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Revised Haz Comm Standard
The Hazard Communication Standard has aligned with the
UN Globally Harmonized System of Classification and
Labeling of Chemicals (GHS):
• Provides common and coherent approach to classifying
chemicals and communicating hazard information on
labels and safety data sheets (SDS)
• Improves quality and consistency of hazard information,
making it safer for workers by providing easily
understandable information on handling and safe use of
hazardous chemicals
Major changes to Haz Comm
Standard
• New Hazard classifications
• New Labeling requirements
Changes
– Signal words (Danger or Caution),
pictograms, hazard statements,
precautionary statements
• Standardized Safety Data Sheets (SDS)
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Previous Labeling - NFPA
Safety Diamond
Flammability
Assign a number to reflect
the degree of hazard to the
worker
Health
Reactivity
RATING SYSTEM: 0-4
The higher the number, the
higher the hazard!
Special Hazard
Label all secondary containers with product and hazard information!
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New GHS Labeling
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New
Pictograms
and Hazard
Classes on
Labels and
Safety Data
Sheets
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Safety Data Sheets (SDS)
– Your Guide to Workplace Safety
• Material Safety Data
Sheets are now called
Safety Data Sheets (SDS)
• SDS will be uniform, with
the same 16 sections in
the same order
• SDS will have:
– Signal word (Danger or
Warning)
– Hazard Pictograms
– Hazard Statements
– Precautionary Statements
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Accessing SDS &
Chemical Inventories
• SDS and departmental
inventories are
available on-line at
Hospital intranet,
“Inside SBUMC”,
under “RESOURCES”
or go to: http://asamsds.campus.stonybro
ok.edu/
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Accessing Pharmaceutical SDS
• On the Hospital Intranet
page, scroll down to
Resources.
• Select drop down for Drug
References and Select
MicroMedex.
• Type in the name of the drug
in the search field and click
“Search”.
• Scroll down and click on the
"Toxicology and Exposure
Information" section.
• Click on MSDS.
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Safety Data Sheets (SDS)
Look for the red arrows
throughout the MSDS
sections.
Why are SDS important to me?
Provides details on:
1. Hazards
2. How to be protected
from injury or illness
– What PPE to wear
– Safe work practices
– Exposure controls
3. What to do if a spill
occurs
4. What to do if a coworker or I get
exposed
– First aid
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SDS Review
Review
of buffered,
a Sample
SDS
• Formalin Solution,
neutral
10%
– Sigma Aldrich
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SDS Review
16 sections:
1.
2.
3.
4.
5.
6.
Identification
Hazards Identification
Composition/Ingredients
First Aid Measures
Fire Fighting Measures
Accidental Release
Measures
7. Handling & Storage
8. Exposure Controls &
Personal Protection
9. Physical & Chemical
Properties
10. Stability & Reactivity
11. Toxicological Info.
12. Ecological Info.
13. Disposal Info.
14. Transport Info.
15. Regulatory Info.
16. Other Info.
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SDS – Section 1
Section 1 - Identification
In case of an
emergency.
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SDS – Section 2
Section 2 - Hazards Identification
How can this product
harm me if
improperly handled?
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2. Hazards ID – Pictograms, Hazard
You need to know how
Statement, Precautionary
statement
this chemical
could harm
you, if not handled
properly
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SDS – Section 3
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SDS – Section 4
Section 4 – First Aid Measures
What do I do if this
chemical get on my
skin, in my eyes, or if I
breathe it in?
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SDS – Section 5
Section 5 – Firefighting Measures
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SDS – Section 6
What do I do for a
release or spill ?
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Spill Kits for Minor
Chemical Spills
Glutaraldehyde Spill Kits
Located near GUS stations and areas where
glutaraldehyde/Cidex OPA used
Chemotherapy Spill Kits
Located in areas where chemotherapy are
prepared and administered
Formalin Spill Kits
Located in labs and areas using formalin
Battery Acid Spill Kits
Located in powered industrial truck charging
areas and other non-alkaline battery areas.
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Chemical Spill Response
• Minor spills of less than a gallon can
be cleaned up by trained staff using
a spill kit (chemo spills: < 50 ml).
• Major spills over 1 gallon, call
University Police at 911 (cell: 631632-3333).
– Offsites: call 911
If at any time during clean up of a minor spill, you need
assistance, call 911 (631-632-3333).
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SDS – Section 7
Section 7 – Handling & Storage
How should I
handle and store
this product
safely?
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SDS – Section 8
Section 8-Exposure Controls & Personal
Protection
How much can I be
exposed to without
experiencing problems?
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Section 8 – Personal
Protection
What must I wear to
protect myself…
gloves, goggles,
respirator?
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SDS – Section 9
Section 9 – Physical & Chemical Properties
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SDS – Section 10
Section 10 – Stability & Reactivity
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SDS – Section 11
Section 11 – Toxicological Information
How can this product harm
me?
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SDS – Section 12
Section 12 – Ecological Information
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SDS – Section 13
Section 13 – Disposal Considerations
How should I
dispose of this
product safely?
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SDS – Section 14
Section 14 – Transport Information
What must I
do if I need to
ship this
product?
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SDS – Section 15
Section 15 – Regulatory Information
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SDS – Section 16
Section 16 – Other Information
Codes used in
Section 3
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Questions or Comments?
• Contact EH&S at 4-6783
– Ask to speak to a staff member in
the Healthcare Safety team!
• Email us at
[email protected]
• Review Admin and EH&S P&Ps at
Inside SBUMC under “Policies &
Procedures”
• For additional reference material go to:
www.stonybrook.edu/ehs/healthcare
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