OSHA regulations require that health care facilities provide employees with all personal protective equipment (Figure 4-13) necessary to protect them from hazards encountered during the course of work. This usually includes plastic shields or goggles to protect workers from droplets, disposal containers for sharp objects, holders for glass bottles, trays in which to carry smaller hazardous items (e.g., blood culture botdes), handheld pipetting devices, impervious, gowns, laboratory coats, disposable gloves, masks, safety carriers for centrifuges (especially those used in the AFB laboratory), and HEPA respirators.
HEPA respirators are required for all health care workers, including phlebotomists, who enter rooms of patients with tuberculosis, and also to clean up spills of pathogenic microorganisms (see Chapter 64). All respirators should be fit-tested for each individual so that each person is assured that his or hers is working properly. Males must shave their facial hair to achieve a tight fit. Respirators are assessed for safety by the National Institute for Occupational Safety and Health (NIOSH), a branch of CDC. N95 or P100 disposable masks (available from 3M, St. Paul, Minn) are commonly used in the clinical laboratory.
Microbiologists should wear laboratory coats over their street clothes, and these coats should be removed before leaving the laboratory. Most exposures to blood-containing fluids occur on the hands or forearms, so gowns with closed wrists or forearm covers
and gloves that cover all potentially exposed skin on the arms are most beneficial. 3 the laboratory protective clothing becomes contaminated with body fluids or potential pathogens, it should be sterilized in an autoclave immediately and cleaned before reusing. The institution or a uniform agency should clean laboratory coats; it is no longer permissible for microbiologists to launder their own coats. Alternatively, disposable gowns may be used. Obviously, laboratory workers who plan to enter an area of the hospital where patients at special risk of acquiring infection are present (e.g., intensive care units, the nursery, operating rooms, or areas in which immunosuppressive therapy is being administered) should take every precaution to cover their street clothes with clean or sterile protective clothing appropriate to the area being visited. Special impervious protective clothing is advisable for certain activities, such as working with radioactive substances or caustic chemicals. Solid-front gowns are indicated for those working with specimens being cultured for mycobacteria. Unless large-volume spills of potentially infectious material are anticipated, impervious laboratory gowns are not necessary in most microbiology laboratories.
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