Biology Safety - LAB2.4 Generic assessment for the lab use of hypodermic needles

Risk factors for consideration.

Bearing in mind that very little work is done in Department laboratories involving human material, the actual risk of infection from human material is low and should be kept in perspective. Having said that, actual risks of infection depend on;

whether the needle was used to transfer samples from a person (or human tissue) infected with hepatitis or HIV viruses

how much infected material enters the body - a needle attached to a syringe containing blood is likely to present a higher risk than a detached needle

how long since the infected needle was discarded - both Hepatitis B and HIV can survive weeks or months, particularly if not dried out

in the case of Hepatitis B or tetanus, whether or not the injured person is immune.

With hazardous chemicals in a needle the risk depends on the properties of the chemical. Only tiny amounts are likely be transferred in a needlestick injury

Who is at risk from needlestick injury?
In the laboratory situation inadvertent needlestick injuries are likely to fall into one of 2 categories;

"Accidental" self-inoculation by the worker using the needle. This can largely be prevented by adequate training of individual workers (in the safe use and prompt disposal of needles into suitable disposal containers sited next to them), the provision of adequate supervision and the adoption of safe working procedures. The competence of individual workers is considered in this assessment (see attached Supervision Record). Should self-inoculation occur the individual will be aware of the nature of any hazard likely to have been injected and he/she can take appropriate action (for personal safety - based on the degree of hazard - and also for reporting the incident - refer to "Reporting Procedure ........" at the end of this document).
"Collateral" injury to ancillary staff (such as porters, lab. assistants, plumbers, laundry workers and waste disposal contractors) caused by the careless or improper disposal of the needle by the user. As the nature of any contamination is unknown, it is likely that the fear of infection or poisoning, and the associated psychological trauma, is the major hazard in this situation. Consequently, this category of needlestick injury can have more severe consequences. The risk from this category of injury can be prevented by the same means as in the previous category, namely, the training, supervision and safe working of the users.

Risk control measures.

Using the needle. It is the unsheathed needle that offers the hazard and it must be made safe. There are 3 obvious control options that might prevent injury to the user and any other person concerned with work in the laboratory or support services. After using the needle;

place the unsheathed needle (as used - either attached to a syringe or free) in a dedicated receptacle with impervious walls (a Sharpsbin). This is the recommended option.

resheathing (placing the needle back in its plastic sheath). This can be accomplished safely (see next paragraph) but is not recommended. The sheathed needle must be disposed of correctly or stored safely.

cutting the needle so the sharp end falls into a suitable container. This is not recommended as the cutting process can generate aerosols of the (possibly hazardous) liquid contained within the needle.

Resheathing of the hypodermic needle can be accomplished safely, depending on the hazard of the material in the needle. Having removed the unused needle from the sheath (directly onto a syringe if using one), the simplest means is to place the sheath on a level surface with the opening towards the operator. After use the needle is guided into the sheath and lifted so the sheath falls over it. Alternatively, commercial devices, such as "Needle Guard" and "Safe T Cap" can be purchased. These hold the sheath in such a way that the needle can be inserted into the sheath in a one-handed operation. If required, the sheathed needle can then be detached safely from the syringe and placed promptly in the Sharpsbin.

Disposal of the needle. Providing the operator has convenient access to a Sharpsbin the disposal need not be delayed. Needles (sheathed or unsheathed) must not be allowed to fall onto the floor and get left there, nor should they be just left on a bench. Some Sharpsbins have devices in their lids to facilitate the removal of needles (sheathed or unsheathed) from syringes so they fall directly into the Sharpsbin. Sharps containers must conform to the relevant standards (BS7320 and UN3291). Three different sized Sharps containers are available from Central Stores;

0.6 litre
5 litre
10 litre

They can be autoclaved at any time, both during a period of use and after, to inactivate any biological contamination. When full (as indicated by the fill-line printed on the Sharpsbin and not when items protrude through the opening) the sealing closures must be made secure and they should be taken to the autoclave room, unless an overt chemical or radiochemical hazard is known to be present in which case they should not be autoclaved. After autoclaving the tops should be additionally secured with packaging tape. The Sharpsbins will be collected, on demand, by the Contaminated and Hazardous Waste Service. Full Sharpsbins are sent for incineration as clinical waste.

Report needle "finds" (hypodermic needles which are found lying on floors). If a sheathed needle on the floor is stepped on the sheath may break exposing the needle. Use an incident report form (see below) and ensure that someone sheaths the needle safely before it is picked up. Do not discard it (in a Sharpsbin) until any investigation as to it's source has finished. It might be possible to find out where it came from. Information about needle finds will be invaluable in Departmental assessments.

First aid treatment for needlestick injuries.

Encourage the puncture wound to bleed.

Wash well under running water without soap and cover with a dry dressing.

Seek medical advice if it isn't known what the needle was used for or if it is known that hazardous materials were involved in it's prior use.

Record the incident and the action taken (see below).

Reporting procedure in the event of an incident (actual needlestick injury or a needle "find"). The University Safety Officer (Peter Adams, WH 3.19, ext 6834, e-mail P.C.E.Adams@bath.ac.uk) should be contacted immediately a needlestick injury occurs. (Leave a message outside normal working hours.) An Incident Report Form (copies of which are available in all first aid boxes) must be completed as soon as possible after the incident or needle find and sent to the Safety Office. The University Medical Officer will be made aware of an injury by the Safety Officer and appropriate medical advice given and other relevant actions taken. Within 48 hours of a needlestick injury a protective injection can be given against Hepatitis B.

This assessment was drafted by Peter Jewell and originally adopted by the Safety Team in May 1998 and reviewed in April 2000, May 2001, May 2003 and May 2005.
It will be reviewed again in May 2007.

Signed by Peter Jewell
Departmental Safety Co-ordinator

Signed by Professor Jonathan Slack,
Head of Department
1st June 2005

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	LAB2.4 - Generic risk assessment for the lab use of hypodermic needles
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Safety home page Our system of managing safety Safety policies Safety A-Z index Risk assessments Generic assessments LAB2.4 - for the lab use of hypodermic needles Useful information Legal requirements	The use and disposal of hypodermic needles is a high risk activity These notes are not exhaustive. The "Useful information" link gives useful safety data for lab-based work. Further information on aspects of occupational health and safety can be found on the safety noticeboard (adjacent to the senior technician's office - 4S 0.14) and in the University of Bath Safety Manual (a copy of which is held in the Departmental Office).
	Exclusions	Is it necessary to use hypodermic needles?
	Hazards of hypodermic needles	Risk factors for consideration
	Who is at risk from needlestick injury?
	Risk control measures;
	Using the needle	Resheathing the hypodermic needle
	Disposal of the needle	Report needle "finds"
	First aid treatment for needlestick injuries	Reporting procedure in the event of an incident

Exclusions. This model assessment does not account for the use of hazardous materials in hypodermic needles. (A Special Assessment is required for such activities.) Is it necessary to use hypodermic needles? In laboratory situations the use of hypodermic needles should be minimised. They should not be used (when attached to a syringe) as substitutes for pipettes. Metal needles may be substituted by cannulae or fine plastic tubing. Gadgets for removing septum caps from reagent bottles are available, thus allowing conventional pipettes or pipettors with plastic tips to be used. The deliberate use of hypodermic needles to introduce material into, or take blood from, humans is only permitted by qualified medical staff or, with animals, Home Office personal licence holders. Hazards of hypodermic needles. "Needlestick" injuries. Hypodermic needles are designed to penetrate body tissues, to facilitate the introduction of fluids or to remove blood. Thus a penetrating injury with a needle is very likely to introduce material contained inside the needle (and syringe if attached) into the body. Material on the outside of the needle may also be introduced into the wound. As a consequence, work using needles containing pathogenic micro-organisms or other hazardous materials will require a Special Assessment. The major biological hazard from needles contaminated with human material are infections of hepatitis B and C and Human Immunodeficiency (HIV) viruses. The hepatitis viruses are more infectious than HIV and can also kill. For needles contaminated with soil (earth) or dirt on floors there could also be a risk from tetanus. For needles used in transferring chemicals the hazard depends on the properties of the individual chemical. Following a needlestick injury where the use of the needle (and hence the needle contents) is not known there may be severe psychological trauma due to the fear of acquiring an infection or from a fear of poisoning. Hence the user MUST ensure that all needles, regardless of the use to which they are to be put, are obtained, used and disposed of with great care (see section "Risk Control Measures"). There will also be a degree of physical injury caused by penetration and/or scratching. Risk factors for consideration. Bearing in mind that very little work is done in Department laboratories involving human material, the actual risk of infection from human material is low and should be kept in perspective. Having said that, actual risks of infection depend on; whether the needle was used to transfer samples from a person (or human tissue) infected with hepatitis or HIV viruses how much infected material enters the body - a needle attached to a syringe containing blood is likely to present a higher risk than a detached needle how long since the infected needle was discarded - both Hepatitis B and HIV can survive weeks or months, particularly if not dried out in the case of Hepatitis B or tetanus, whether or not the injured person is immune. With hazardous chemicals in a needle the risk depends on the properties of the chemical. Only tiny amounts are likely be transferred in a needlestick injury Who is at risk from needlestick injury? In the laboratory situation inadvertent needlestick injuries are likely to fall into one of 2 categories; "Accidental" self-inoculation by the worker using the needle. This can largely be prevented by adequate training of individual workers (in the safe use and prompt disposal of needles into suitable disposal containers sited next to them), the provision of adequate supervision and the adoption of safe working procedures. The competence of individual workers is considered in this assessment (see attached Supervision Record). Should self-inoculation occur the individual will be aware of the nature of any hazard likely to have been injected and he/she can take appropriate action (for personal safety - based on the degree of hazard - and also for reporting the incident - refer to "Reporting Procedure ........" at the end of this document). "Collateral" injury to ancillary staff (such as porters, lab. assistants, plumbers, laundry workers and waste disposal contractors) caused by the careless or improper disposal of the needle by the user. As the nature of any contamination is unknown, it is likely that the fear of infection or poisoning, and the associated psychological trauma, is the major hazard in this situation. Consequently, this category of needlestick injury can have more severe consequences. The risk from this category of injury can be prevented by the same means as in the previous category, namely, the training, supervision and safe working of the users. Risk control measures. Using the needle. It is the unsheathed needle that offers the hazard and it must be made safe. There are 3 obvious control options that might prevent injury to the user and any other person concerned with work in the laboratory or support services. After using the needle; place the unsheathed needle (as used - either attached to a syringe or free) in a dedicated receptacle with impervious walls (a Sharpsbin). This is the recommended option. resheathing (placing the needle back in its plastic sheath). This can be accomplished safely (see next paragraph) but is not recommended. The sheathed needle must be disposed of correctly or stored safely. cutting the needle so the sharp end falls into a suitable container. This is not recommended as the cutting process can generate aerosols of the (possibly hazardous) liquid contained within the needle. Resheathing of the hypodermic needle can be accomplished safely, depending on the hazard of the material in the needle. Having removed the unused needle from the sheath (directly onto a syringe if using one), the simplest means is to place the sheath on a level surface with the opening towards the operator. After use the needle is guided into the sheath and lifted so the sheath falls over it. Alternatively, commercial devices, such as "Needle Guard" and "Safe T Cap" can be purchased. These hold the sheath in such a way that the needle can be inserted into the sheath in a one-handed operation. If required, the sheathed needle can then be detached safely from the syringe and placed promptly in the Sharpsbin. Disposal of the needle. Providing the operator has convenient access to a Sharpsbin the disposal need not be delayed. Needles (sheathed or unsheathed) must not be allowed to fall onto the floor and get left there, nor should they be just left on a bench. Some Sharpsbins have devices in their lids to facilitate the removal of needles (sheathed or unsheathed) from syringes so they fall directly into the Sharpsbin. Sharps containers must conform to the relevant standards (BS7320 and UN3291). Three different sized Sharps containers are available from Central Stores;
0.6 litre 5 litre 10 litre		Stores code 3822346 Stores code 3822352 Stores code 3822369
They can be autoclaved at any time, both during a period of use and after, to inactivate any biological contamination. When full (as indicated by the fill-line printed on the Sharpsbin and not when items protrude through the opening) the sealing closures must be made secure and they should be taken to the autoclave room, unless an overt chemical or radiochemical hazard is known to be present in which case they should not be autoclaved. After autoclaving the tops should be additionally secured with packaging tape. The Sharpsbins will be collected, on demand, by the Contaminated and Hazardous Waste Service. Full Sharpsbins are sent for incineration as clinical waste. Report needle "finds" (hypodermic needles which are found lying on floors). If a sheathed needle on the floor is stepped on the sheath may break exposing the needle. Use an incident report form (see below) and ensure that someone sheaths the needle safely before it is picked up. Do not discard it (in a Sharpsbin) until any investigation as to it's source has finished. It might be possible to find out where it came from. Information about needle finds will be invaluable in Departmental assessments. First aid treatment for needlestick injuries. Encourage the puncture wound to bleed. Wash well under running water without soap and cover with a dry dressing. Seek medical advice if it isn't known what the needle was used for or if it is known that hazardous materials were involved in it's prior use. Record the incident and the action taken (see below). Reporting procedure in the event of an incident (actual needlestick injury or a needle "find"). The University Safety Officer (Peter Adams, WH 3.19, ext 6834, e-mail P.C.E.Adams@bath.ac.uk) should be contacted immediately a needlestick injury occurs. (Leave a message outside normal working hours.) An Incident Report Form (copies of which are available in all first aid boxes) must be completed as soon as possible after the incident or needle find and sent to the Safety Office. The University Medical Officer will be made aware of an injury by the Safety Officer and appropriate medical advice given and other relevant actions taken. Within 48 hours of a needlestick injury a protective injection can be given against Hepatitis B.

This assessment was drafted by Peter Jewell and originally adopted by the Safety Team in May 1998 and reviewed in April 2000, May 2001, May 2003 and May 2005. It will be reviewed again in May 2007.	Signed by Peter Jewell Departmental Safety Co-ordinator	Signed by Professor Jonathan Slack, Head of Department 1st June 2005

LAB2.4 - Generic risk assessment for the lab use of hypodermic needles