Chemical Hygiene Plan

 Introduction/Responsibilities/Chemical Hygiene Principles

Basic Rules and Guidelines
General Standard Operating Procedures
Chemical Safety Protocols

Chemical Hygiene Practices

Signs and Labels
Laboratory Environment Protection
Hazard Assessment and Knowledge
Chemical Inventory
Chemical Handling
Chemical Storage
Chemical Waste Disposal

Chemical Hygiene Services and Resources

Chemical Exposure Monitoring
Medical Surveillance and Consultation
Inspections and Assessments
Laboratory Facilities and Equipment
Chemical Safety Committee
Incidents

Emergency Information

Chemical Spill guidelines
Safety Information for Chemicals

Laboratory Fire and Life Safety

Personal Injuries and Incidents
Power Outages and Major Maintenance Matters

Appendices

Glossary

INTRODUCTION

This Chemical Hygiene Plan (CHP) is provided for research laboratories in order to supply clear information and guidance for chemical users in varied and complex environments.  The CHP covers the basic requirements of the Occupational Safety and Health Administration’s Standard 29 CFR 1910.1450, “Occupational Exposure to Chemicals in Laboratories”.  The CHP serves, secondarily, as a Laboratory Safety Manual by providing a framework for safe science and access to additional helpful resources.

Throughout this Plan the term chemical “hygiene” refers to “conditions or practices that serve to promote or preserve health” when working with or around chemicals.

Policy

The intention of the Chemical Hygiene Plan is to set forth principles, practices and information for laboratory chemical users.  The goal is to provide a safe and healthy environment for the conduct of research which is consistent with regulatory standards and best practices.

This   Plan or Manual supplements the WFSM Hazard Communication Program; however, it is not designed to provide an exhaustive hazard explanation of all chemicals potentially available in a research environment. Inherent to the practice of safe science is the pursuit of reasonably full understanding of the hazards of the chemicals used in research activities and experiments.  The burden lies with the principal investigator to entrain a culture of safety in the laboratory setting.

Scope  

The Chemical Hygiene Plan extends to all research laboratory operations within the jurisdiction of Wake Forest School of Medicine.  This includes all campuses and facilities; and all faculty and staff.

Biosafety
Radiation Safety

RESPONSIBILITIES

The Dean and Department Chairs are responsible for establishing and maintaining compliance with the Chemical Hygiene Plan.

The Chemical Safety Committee is a Dean appointed committee responsible for recommending policies, procedures, and programs to provide an environment free of chemical hazards and promote good stewardship of the environment. The full responsibilities of the Chemical Safety Committee are outlined in Section IV of the Organization and Policies Manual, Wake Forest School of Medicine.  The implementation and evaluation of the determinations of the Committee are managed by Environmental Health and Safety.

The Principal Investigator has responsibility for overall conformity with the CHP within the laboratory.  This responsibility should not be delegated to inexperienced or inadequately trained personnel.  The PI must assure that:

• laboratory facilities and equipment are maintained and operated in a safe manner.  Hazardous conditions should be reported to the Department Chair/Director, Engineering, and Environmental Health and Safety.
• personal protective equipment (PPE) appropriate to present hazards is provided and worn by laboratory workers.  This may include lab coat, safety glasses, gloves and closed toe footwear.
• safety policies and procedures (e.g. Chemical Hygiene Plan, General Standard Operating Procedures, Chemical Safety Protocols) are provided, explained and understood prior to working with hazardous chemicals.  This includes explanation of the proper use and operation of engineering controls such as fume hoods and biosafety cabinets.
• PeopleSoft hazard assessments are current for all laboratory personnel.
• Chemical inventories are reviewed regularly in order to eliminate, replace, or reduce chemicals in use.  Flammable chemical quantities must be maintained at or below the level dictated by the NC Fire Code.

Individual laboratory workers including volunteers, visiting professionals, graduate students and research fellows are responsible for:

• wearing appropriate personal protective equipment (PPE) such as lab coat, safety glasses, gloves and closed toe footwear.
• including diligent safety considerations in the planning of laboratory experiments and activities.  Knowledge of the content of the Chemical Hygiene Plan, General Standard Operating Procedures and applicable Chemical Safety Protocols is expected.
•  developing proficient laboratory hygiene practices.
• completing suitable training as provided by the Principal Investigator, Environmental Health and Safety and notable reference publications such as Prudent Practices in the Laboratory.

Environmental Health and Safety (EH&S) is responsible for collaborating with the Chemical Safety Committee, faculty, staff, students, and others to develop and implement appropriate chemical hygiene practices and procedures. EH&S provides direction and consultation for laboratory workers as follows:

• The director of EH&S or designee shall be assigned as the Chemical Hygiene Officer.
• Conducts periodic laboratory assessments to determine each laboratory’s safety and health performance.  This assessment is organized in cooperation with the Principal Investigator and the lead laboratory technician and corrective and instructive actions prompted.
• Maintains a Chemical Management Inventory System (CMIS) which provides access to Material Safety Data Sheets and chemical hazard and handling information. 

Provides general and specific laboratory safety training and education as required by regulatory standards, institutional policies and/or best practices.             

CHEMICAL HYGIENE PRINCIPLES

Chemical hygiene within laboratories is practiced on three levels:

• Basic Rules and Guidelines
• General Standard Operating Procedures
• Chemical Safety Protocols

These three levels are depicted by the pyramid diagram below. 

Basic Rules and Guidelines apply to work with all chemicals by all workers.

General Standard Operation Procedures are guidelines for working with specific hazardous chemicals which are used in many laboratories within the institution.  Working with these chemicals requires judicious attention to the applicable SOP.  In no case, should these chemicals be used without consulting the General SOP. 

Chemical Safety Protocols are specific procedures developed by the laboratory for use with a particular hazardous chemical.  Use of these chemicals requires approval from the Chemical Safety Committee.

 

The greater the risk to the worker due to the hazard properties of the chemical, the greater the expected level of knowledge, protection and practices.

Basic Rules and Guidelines for All Laboratory Work with Chemicals

The following rules and guidelines, while not exhaustive, lay a strong foundation for personal safety and health while working with laboratory chemicals. 

1. Minimize exposure to chemicals. 
   • Preparation
   • Source reduction:  use the smallest amount.
   • Substitution:  use less toxic alternative chemicals.
   • Ventilation
   • Practices
   • Protective wear
   • First response to overexposure
2. Maintain professional standards of personal behavior, dress, and hygiene.  Eating, drinking, applying cosmetics, gum chewing, taking medications (and similar activities) are prohibited in wet lab areas.  Chemicals should not be intentionally smelled, tasted or inhaled.
3. Know basic and pertinent information about the chemicals you are using.
   • Physical, chemical and toxicological properties
   • Physiological effects
   • How the chemical may enter the body:  inhalation, through contact with skin or eyes, injection, ingestion.
4. Use chemicals only with adequate ventilation.  A chemical fume hood should be used as a primary means of protection from exposure.
5. Use personal protective equipment to minimize contact exposure to chemicals:  lab coat, safety glasses (or goggles), nitrile gloves, and closed toe shoes.  Based upon chemical properties additional protection may be necessary, e.g. face shield, rubber gloves, rubber apron.
6. Practice hand hygiene.  Wash hands (with soap and water) and exposed skin thoroughly after handling any chemical and whenever leaving a lab room.
7. Label every chemical container with chemical name and warning information. 
8. Use laboratory equipment sensibly:
   • What is the equipment used for?
   • Be familiar with written operating procedures and/or technical manuals.
   • Understand the hazards and limitations of the equipment.
   • Can the equipment be left unattended?  Under what circumstances and arrangements?
9. Use the “buddy” system when working in a laboratory.  Working alone is risky.
10. Be prepared for accidents and unplanned events.  Know and practice basic emergency response for chemical related accidents and spills.
11. Maintain a current PeopleSoft Hazard Assessment for each laboratory worker, including the PI.
12. Security and safety are complementary responsibilities.  Laboratory doors should be kept locked when not occupied.  Those without proper authorization or standing are not allowed in laboratory areas, e.g. minors, unescorted visitors and vendors.

GENERAL STANDARD OPERATING PROCEDURES (SOPs)

The Basic Rules and Guidelines presented in the previous section apply to working with all chemicals.  Many thousands of chemicals are encountered in WFUHS research laboratories.  It is not reasonable to provide specific, detailed information for all.  However, for some chemicals which are used broadly within the research environment, Standard Operating Procedures have been developed.  These SOPs serve as “substance safety summaries” given that these chemicals may be highly toxic, flammable, highly reactive or explosive.  Each SOP contains the following categories of information (at a minimum):

• Physical hazards
• Health hazards
• Personal Protective Equipment
• Designated area for use and containment equipment
• Special handling procedures and storage requirements
• Waste disposal
• Decontamination of equipment and area
• Spill and emergency procedures
• Medical surveillance

Click here to access the list of General Standard Operating Procedures for particular chemicals.  Laboratory workers who use these chemicals must review, understand and comply with the pertinent SOP.

Prudent Practices in the Laboratory provides Laboratory Chemical Safety Summaries for 88 substances commonly used in laboratories.  These summaries should be consulted and applied vigorously.

CHEMICAL SAFETY PROTOCOLS 

Specific laboratory developed chemical safety protocols are required when using particularly hazardous chemicals in the following categories:

• carcinogens,
• reproductive toxins,
• highly acute toxicity,
• select agent toxins,
• hazardous drugs, air or
• water reactive and
• nanomaterials

Discussion of these chemicals and regulatory listings are available in the Particularly Hazardous Chemicals policy issued by Environmental Health and Safety. 

The Chemical Safety Protocol is developed in concert with the Chemical Safety Committee.  The Chemical Safety Committee will provide guidance, review and approval of the Chemical Safety Protocol.

Companion Resources:

CHEMICAL HYGIENE PRACTICES

Signs and Labels

Room Signs

A visual display or sign will be present at the primary entrance to each research laboratory room.  The sign will convey safety, health and emergency contact information significant to the room.  This information is primarily for use by those not intimately familiar with the present hazards, such as housekeeping, engineering, official visitors, security, and public safety personnel.  The information on the sign is fundamentally the responsibility of the Principal Investigator; however, Environmental Health and Safety validates and creates the signs for each lab.  If a new sign is required or if changes are indicated for an existing sign, contact Environmental Health and Safety at ehs@wakehealth.edu.

Each laboratory sign is comprised of four primary sections.  Section 1 provides the department name and the room number.

Basic personal protective equipment (PPE) for the lab is recommended in section 2.

Section 3 supplies hazard information which is both general and specific:

• Radioactive materials
• Laser
• Biohazard
• Magnetic field
• Designated chemical area within:  carcinogen, e.g.  teratogen, reproductive toxin
• Special hazard chemicals such as air and water reactive, flammable gas.

In the center of this section an NFPA diamond presenting hazard information is placed.  This diamond is the primary hazard identification system for firefighters.  The hazard categories are conveyed by color:

• Red:  flammability
• Blue:  health
• Yellow:  reactivity
• White:  special hazard

The numbers in the red, blue and yellow sections designate hazard severity (0 to 4, with 4 being the most hazardous).  The white section, if used, will contain a symbol.

Figure ___ represents the NFPA diamond symbol for the chemical, methanol:

Section 4 lists laboratory and emergency contact numbers.

Additional Signage

Supplementary signs and information will be necessary as determined by laboratory and equipment operations.  The list below is illustrative, not exhaustive:

• Hand washing and non-hand washing sinks
• Safety showers and eye wash stations
• Refrigerators/freezers (prohibited items)
• First aid equipment
• Unattended processes
• Particularly hazardous chemical designated working area, e.g. benzene, formaldehyde (carcinogen)
• Biohazard
• Radiation hazard
• Laser
• Magnetic field

Labels

A label is written, printed or graphic matter affixed to a chemical container to furnish identification and/or other information.  Labeling guidelines:

• All chemical containers, including beakers, flasks, bottles, reaction vessels and process equipment should be labeled.
• Durable, readable and understandable to laboratory and emergency workers. 
• Include the chemical name, hazard components and warnings.
• Gas cylinders should be labeled with contents in addition to the manufacturer’s color code scheme.

Chemicals transferred from a primary labeled container to a secondary container (e.g. safety cans and squeeze bottles) should be identified with chemical name/synonyms, warning words, and any acute first aid information.

Signal words are often used to designate the degree of hazard present.  A common hierarchy of hazard warning:

Danger:  highest degree of hazard (Red)

Warning:  intermediate degree of hazard (Orange)

Caution: lowest degree of hazard (yellow)

Companion Resources

Laboratory Worker Protection

Basic Strategies

Protecting laboratory workers from chemical exposure (and exposure to other hazards) is approached from three perspectives:

1. Engineering controls are means used to remove or reduce hazard exposure through
   • Substituting a less hazardous or non-hazardous chemical
   • Enclosing the process, e.g. fume hood, biosafety cabinet, glove box, point source ventilation
   • General ventilation system of 6 to 12 room air changes per hour in a laboratory room.
2. Administrative controls
   • Education and training informs laboratory workers of proper hazard assessment and methods of protection from personal exposure.  This knowledge should lead to sound chemical hygiene choices.
   • Written policies and procedures.
   • Arranging laboratory worker schedules to limit the duration of exposure to health hazards.
   • Transferring workers from areas where they may be particularly sensitive to a given chemical(s) or have reached the limit of acceptable exposure.
3. Personal protective equipment
   • Personal protective equipment (PPE) is a broad category referring to devices and apparel which are worn to provide protection from hazards in the laboratory environment, e.g. lab coat, gloves, safety glasses, respirator.
   • PPE is considered secondary protection since hazards are not eliminated or reduced. A barrier is placed between the laboratory worker and the present hazard.

Laboratory Fume Hoods and Other Types of Engineering Controls

Laboratory fume hoods or “chemical fume hoods” are the most common and effective engineering method used in a laboratory setting to protect laboratory workers from chemical hazards.  Work with toxic substances may result in the generation aerosols and vapors.  The fume hood serves as a physical barrier between the laboratory worker and chemical exposure. 

Explanatory note:  A fume hood and a biosafety cabinet are vastly different in purpose and operation. A biosafety cabinet is used for protection against exposure to biohazardous materials.  Chemicals should not be used in a biosafety cabinet unless is it is specially vented. Detailed information on biosafety cabinets is presented in the Biosafety Manual.

Using a Fume Hood

Prudent Practices in the Laboratory (National Research Council, 1981 and 1995) offers the following guidelines for safe and efficient use of a laboratory fume hood:

1. Keep fume hood exhaust fans on at all times. (If inadequately hood performance is suspected, contact Engineering and EH&S.  Do not perform work in the hood until it has been adequately evaluated.)
2. Except when adjustments of apparatus within the hood are being made, the hood should be kept closed: vertical sashes down and horizontal sashes closed. Sliding sashes should not be removed from horizontal sliding-sash hoods. Keeping the face opening of the hood small improves the overall performance of the hood.
3. If possible, position the fume hood sash so that work is performed by extending the arms under or around the sash, placing the head in front of the sash, and keeping the glass between the worker and the chemical source.  The worker views the procedure through the glass, which will act as primary barrier if a spill, splash, or explosion should occur.
4. Avoid opening a closing the fume hood sash rapidly, and avoid swift arm and body movements in front of or inside the hood.  The actions may increase turbulence and reduce the effectiveness of fume hood containment.
5. Place chemical sources and apparatus at least 6 inches behind the face of the hood.  Quantitative fume hood containment tests reveal that the concentration of contaminant in the breathing zone can be 300 times higher from a source located at the front of the hood face than from a source placed at least 6 inches back.
6. Hoods are not intended primarily for storage of chemicals. Materials stored in them should be kept to a minimum. Whenever practical, chemicals should be moved from hoods into cabinets for storage.
7. Place equipment as far to the back of the hood as practical without blocking the bottom baffle.
8. Separate and elevate each instrument by using blocks or racks so that air can flow easily around or under all apparatus.
9. Do not use large pieces of equipment in a hood, because they tend to cause dead spaces in the airflow and reduce the efficiency of the hood.
10. Hoods should never be used for disposal of hazardous volatile chemicals by evaporation.  These should be treated as chemical waste and disposed of through the EH&S waste program.

Fume Hood Problems, Maintenance and Annual Certification

Prior to using a fume hood, check the following:

• Verify proper vertical or horizontal sash position(s).
• Ensure that there is not excessive turbulence in the hood due to overcrowding.  Eliminate unnecessary equipment and other items.
• If there is a continuous monitoring device, make sure that it is working and that the fume hood parameters are within acceptable limits.
• Report any malfunctioning fume hood to Engineering.  Do not use the hood until proper operation is assured.

C ompanion Resources

 

Electrical Power Loss

If electrical power is lost and the fume hood becomes inoperable, the situation should be carefully evaluated.  If chemicals in the hood are toxic and migrate into the laboratory room, workers should evacuate the area. 

Fume hood maintenance should only be performed by WFUHS Engineering or an authorized commercial technician.  In no case should adjustments or alterations be made by laboratory staff.

Fume hoods are tested and certified (operation within acceptable parameters on an annual basis by Environmental Health and Safety.

 

Walk in Hoods

A walk-in hood is typically a floor to ceiling hood which is used to accommodate tall or large apparatus.  These hoods are primarily of the horizontal sash type.  Though they are called “walk-in”, these hoods should not be entered if hazardous chemical or other operations are present.  Once the plane of the hood is crossed the worker is exposed to whatever hazardous condition exists.

Ductless Fume Hoods

Ductless fume hoods have limited application in a laboratory setting.  These hoods are fundamentally ventilated enclosures with activated carbon filters.  Air flows from the room into the hood, through the filter and is then recirculated into the room.  Only in situations where the hazard risk is very low will these hoods be approved for use.

Glove Box

A glove box is a closed, sealed container which allows manipulation of materials or objects from the outside through the use of mounted, impermeable gloves.  Key glove box characteristics and considerations:

• Usually operate under negative pressure.
• HEPA filters are generally incorporated into the exhaust, to keep the hazard contained.
• Glove box operation will be evaluated annually by EH&S.
• As with all laboratory equipment, operational knowledge of the glove box is essential prior to use.

Prior to purchasing or using a glove box, Environmental Health and Safety should be consulted. 

Perchloric Acid Hoods

This type of hood is specially manufactured equipment for use with perchloric acid and other materials which can deposit shock sensitive metallic perchlorates in the hood and its exhaust components.  Since these materials become pyrophoric when they dry or dehydrate, the hoods are outfitted with a special water spray system to wash down all interior surfaces of the hood and ductwork.

• Construction of perchloric acid hoods must conform to stringent manufacturing specifications.
• Do not use any organic materials, including paper or wood, in a perchloric acid fume hood; contact of hot acid or vapor with such materials may lead to an explosion.
• The exhaust from a perchloric acid hood should not be manifolded with the discharge from other types of hoods.
• Laboratories should contact Engineering after using perchloric acid in the hood.  Engineering will activate the wash down system.

C ompanion Resources:  Perchloric Acid Standard Operating Procedure

Personal Protective Equipment

A laboratory setting is, by its nature, a hazardous environment and requires certain equipment, practices and personal protective wear to provide adequate safeguard for workers.  Below is represented the hierarchy of protective measures:

• a
• b
• c

Personal protective equipment is provided without cost to laboratory workers and others who have occasion to perform cleaning and maintenance work in a laboratory room.  The Principal Investigator is ultimately responsible to assure that laboratory workers wear PPE that is suitable to the hazards present.  At a minimum, laboratory PPE consists of a lab coat (cotton), nitrile gloves, safety glasses and full footwear (no open toed shoes or sandals).

Eye and Face Protection

Hand Protection

Gloves appropriate to the hazard in considered “Standard Precautions” for a laboratory environment.  Glove selection requires careful consideration since the effectiveness of the glove depends upon the hazard properties of the chemical handled.

• A nitrile glove is a good, general glove for normal laboratory activities.
• Latex gloves are not a good choice for working with chemicals since some chemicals readily permeate the latex compound.  This may be true for nitrile gloves, as well.
• Special gloves should be considered for use with highly toxic materials, for tasks involving extensive solvent handling and for working with corrosives.
• Refer to the EH&S Glove Comparison Chart in order to select the best glove for the chemical used.  This chart indicates the relative resistance of various types of gloves to chemical exposure.
• Use insulated, cryogenic or leather gloves for tasks which require considerable additional protection.
• Dispose of contaminated gloves.  Do not leave them unattended on lab benches, etc.
• Wash hands thoroughly after removing gloves.
• Contact EH&S if assistance if needed in the selection of a proper glove for an untried or novel chemical.

C ompanion Resources :

 

 

Inhalation Protection (Respirator Use)

In practically all laboratory situations, the proper use of engineering controls (fume hood, glove box, enhanced room ventilation) should provide adequate respiratory protection.  However, in certain exceptional research situations the additional protection of a respirator may be prudent. Toxic materials can enter the body by means of inhalation, e.g. gases, vapors of volatile liquids, mists and sprays, and solid chemicals in the form of particles, fibers, and dusts.

Types of respiratory protective equipment include:

• particle-removing air purifying respirators (N95, N100)
• gas and vapor-removing air purifying respirators
• air supplied respirators

In no case should a respirator be worn without consultation with EH&S.  There are strict guidelines for medical evaluation, fit testing and training before a respirator is approved for use in a laboratory.

C ompanion Resources :

Body Protection

Routine laboratory operations normally involve small quantities of chemicals; hence it is unlikely that body (skin) protection other than a lab coat (long pants and closed toe shoes) would be necessary.  If a lab anticipates working with chemicals of extreme toxicity or an amount that would require more substantial body covering, EH&S should be consulted.

Protective chemical disposable suits are available in uncommon situations.  EH&S will provide evaluation, fitting and donning instructions in the event such suits are warranted.  As a rule, this kind of protective wear is only used in emergency hazardous materials incidents.

The Position Hazard Verification is the process through which specific hazard exposure is assigned to each faculty and staff member.  This “assessment” forms the foundation of the training programs offered by EH&S.  The Position Hazard Verification is developed through Human Resources PeopleSoft and can be viewed for each person at their individual PeopleSoft Self Service web page.

Proper storage in a research laboratory functions as a fundamental building block of laboratory safety.  Use sources such as MSDSs for guidance about chemical storage, e.g. incompatibility, reactivity, stability. 

General chemical storage guidelines:

• Do not store chemicals alphabetically unless they are segregated by compatible group.
• Do not store chemicals on top of cabinets where they are difficult to reach or see.
• Avoid storing heavy materials up high.  Ensure shelves are adequately secured to walls and are stable.  Contact Engineering if additional support is required.
• Practice clear labeling of all chemical containers.  Put the receipt date on the chemical label to aid in chemical use and rotation.
• Consult CMIS to locate other labs which may have a chemical needed (small quantities).
• Conduct periodic cleanouts to prevent the accumulation of excess or outdated chemicals.
• Avoid storing chemicals on bench tops.  Only chemicals in use should be present on a working bench.
• Refrigerators used for storing chemicals must be labeled “No Food”.  Flammable liquids may only be stored in “explosion proof” refrigerators/freezers.  Household or even commercial grade refrigerators are not an acceptable storage alternative for flammable liquids.
• Do not store chemicals in a fume hood.  Fume hoods are inefficient when crowded with materials.  Only chemicals in use should be present in a hood.
• Install plexiglass lips on storage shelves to prevent accidental spills and breakage.
• Avoid storing chemicals near heat sources or in direct sunlight.  This may lead to container or label deterioration.  Chemical quality may be lessened, as well.

Chemical Incompatibility and Segregation

Inadvertent contact of incompatible materials could result in an explosion or the formation of a toxic or flammable substance, or both.  In order to prevent an undesirable chemical reaction, storage should be dictated by the hazard class of the chemical(s).

Chemical Incompatibility Table   

Secondary Containment for Chemical Liquids

As a standard practice chemical liquids should be stored in some sort of drip tray.  This practice limits the spread of a spill in the event containers leak or spill. Care should be taken to use trays which are chemically resistant to the chemical(s) stored.

• Photo trays are generally good for aqueous solutions and some organic solvents.  They may not be a good choice for halogenated solvents.
• Polypropylene and high density polyethylene trays are subject to degradation from contact with some aromatic and halogenated hydrocarbons.  Check for chemical resistance prior to use.
• Stainless steel and Pyrex trays are resistant to a broad spectrum of chemicals but are more costly and fewer size choices are available.

Flammable and Combustible Liquids Storage

Flammable and combustible liquids are defined by their flash points. The flash point of a liquid is the minimum temperature at which it gives off sufficient vapor to form an ignitable mixture with the air near its surface or within its containment vessel.  A liquid’s flash point is a function of its vapor pressure and boiling point.  Generally, the higher the vapor pressure and the lower the boiling point of a liquid, the lower its flash point will be.  The lower the flash point, the greater the fire and explosion hazard.

Minimizing laboratory inventory levels of stored flammable and combustible liquids is driven by:

• the requirements of the North Carolina Fire Code,
• building construction characteristics and
• life safety good judgment.

Control of flammable and combustible inventory levels is guided by the following principles and procedures:

• Flammable and combustible chemicals should always be stored in an UL listed or FM approved cabinet.  Only those chemicals “in use” may be outside of a cabinet.
• Laboratories are only allowed one 4 gallon Flammable Storage Cabinet if the lab is located in a high rise building (> 4 floors: Hanes, Gray, NRC, RJCST).  Exceptions must be approved by EH&S on a case by case basis.
• All flammable and combustible chemicals are barcoded upon receipt, registered in the Chemical Management Inventory System (CMIS) by location and tracked until the empty container or the barcode is scanned by EH&S.  EH&S conducts regular cycle counts of flammable liquids in laboratories in order to ensure inventory levels are accurate.
• Flammable liquid containers without a barcode should be reported to EH&S.
• Large containers (5 gallon) are not allowed in any lab. 
• Flammable-liquids storage cabinets are not intended for the storage of highly toxic materials, acids, bases, compressed gases or pyrolytic chemicals.

 DIAGRAM 

C ompanion Resources: Classification of Flammable and Combustible Liquids

 

Reactive/Unstable Chemicals

Highly reactive or unstable materials are those that have the potential to vigorously polymerize, decompose, condense, or become self-reactive under conditions of shock, pressure, temperature, light, or contact with another material. Major types of highly reactive chemicals are explosives, peroxides, water-reactives, and pyrophorics.

• Label all chemicals with date received and date opened and if an appropriate expiration date does not exist, assign one.
• Any chemicals with crystallization, visible discoloration, or liquid stratification potentially have undergone peroxidation and must not be used or otherwise disturbed.

Lists:    Chemicals which may form explosive peroxides

            Shock sensitive chemicals

Compressed Gases

Compressed gas cylinders store gases that vary from extremely flammable (acetylene, hydrogen) to inert (helium). Many compressed gas cylinders are stored at extremely high pressures (up to 2,500 pounds per square inch gauge or PSIG).

Compressed and liquefied gases are routinely used in laboratory and various other operations.  Standard precautions and practices are indicated below (more detailed information is provided under Companion Resources.

• Ensure contents of cylinders are properly identified.
• Don't accept unidentified cylinders and don't rely on color codes; read the label.
• Don't destroy or remove identification tags or labels.
• Check to see cylinder valves are protected with protective caps.
• Leave caps on until the gas is about to be used.
• Move cylinders only with a suitable hand truck.
• Do not roll or drop cylinders, or let them bump violently against each other.
• Secure cylinders with a chain or strap positioned around the upper third of the cylinder.
• Small cylinders may be put on their side and blocked to prevent rolling.
• Clear cylinder valves of any dust or dirt before attaching proper regulators.
• Some regulators are only for specific gases; regulators should not be interchanged.
• Do not force connection fittings and never tamper with safety devices in cylinder valves or regulators.
• Release adjusting screw on regulator before opening cylinder valve.
• Stand to the side of the regulator when opening cylinder valve.
• Open cylinder valve slowly.
• Use protective gloves and eye wear when handling cylinders containing cryogenic (super-cold) gases.
• Store cylinders in a well-ventilated area away from all sources of heat or flames.
• Do not store flammable gases next to exit or oxygen cylinders.
• Before returning cylinder, close the valve and replace the protective cap.
• Separate empty and full cylinders during storage.
• Mark empty cylinders "EMPTY".
• Know safety and first-aid requirements for gases being used.
• Review Standard Operating Procedures (SOP), MSDS sheets, and read  warning labels.

C ompanion Resources :

Transporting Small Quantities of Hazardous Materials by Laboratory Workers, Contractors and Vendors

These parties may move small quantities of hazardous materials for short distances within a building or between adjacent buildings, provided that it can be done safely and without spilling the materials. Individuals must use hand carts and drip trays (to contain any spilled material). Use standard cylinder dollies to transport compressed gas cylinders. While dollies are preferred, cylinders weighing 11 Kg (25 lbs) or less may be hand-carried.

Never move a cylinder with a regulator connected to it.  Cylinder valve-protection caps and valve-opening caps must be in place when moving cylinders. Lecture bottles and other cylinders that are not normally equipped with valve-protection caps should be transported in either the original DOT specification package or an equivalent container.

 

It is not expected that the medical surveillance requirements of the above standards will be triggered by normal research operations.  However, in the event a true exposure occurs or exposure monitoring indicates, medical surveillance actions will be taken in regard to the affected employee(s).  Responsibility rests with WFBMC Employee Health Services to initiate appropriate measures, which may include:

 

• Consultation with EH&S and the employee in order to identify the hazardous agent, the conditions of exposure and any signs or symptoms displayed by affected employee.
• Initial medical examination and testing
• Prophylaxis
• Appropriate referral for further examination
• Written opinion regarding the occupational exposure

Inspections and Assessments of Research Laboratories and Associated Facilities

Inspections by External Regulatory Agencies

While not likely, it is possible for officials from external organizations (federal, state, and local) to present themselves and seek entry to WFUHS labs or other facilities.  In this event EH&S should be contacted immediately in order to assist with the site visit.  While these agencies, for the most part, have jurisdiction, there are ground rules which must be followed.  EH&S will ascertain the nature and scope of the visit and accompany the official(s) for the duration of the visit.

Potential inspecting agencies include:

• North Carolina Occupational Safety and Health Administration (NC OSHA)
• North Carolina Radiation Protection Section
• US Environmental Protection Agency Region IV
• NC Department of Environment and Natural Resources (DENR)
• Nuclear Regulatory Administration
• Centers for Disease Control (CDC)
• National Institutes of Health (NIH)
• Winston-Salem Fire Department
• Forsyth County Department of Environmental Affairs
• City of Winston-Salem, Utilities Division

EH&S Laboratory and Area Assessment Program

Ongoing evaluation of safety, health and environmental practices and conditions is an institutional and an individual responsibility at WFUHS.  This responsibility exists on an informal and a formal level for the individual worker, the lab manager and/or the Principal Investigator.  Informally, daily habits and protocols must be rooted in sound and safe practices.  On a more prescribed basis, the following are required:

• A Quarterly Laboratory Self Assessment (completed by the laboratory manager or PI)
• An Annual Assessment (conducted by EH&S)

Quarterly Laboratory Self Assessment

The quarterly lab self assessment is designed to be a quick check by laboratory personnel of key safety and health topics.  Each lab is expected to submit the completed assessment form to EH&S during the first 15 days of each quarter (January, April, July, October).

Annual Assessment by EH&S

Research laboratories are assessed by EH&S at least annually.  Circumstances may dictate more frequent visits if prompted by emerging regulatory demands or safety matters.

The assessment checklist is extensive and demanding, but serves as a clear reference of institutional expectations for research laboratories.  EH&S provides not only evaluation, but assistance in correcting deficiencies and in resolving substantive issues.  Commonly EH&S will provide needed materials or assist labs in obtaining equipment or repairs necessary to ensure safe working conditions.  Normally radiation safety audits will be performed quarterly by EH&S radiation safety staff professionals.  These audits are separate and distinct from the laboratory assessment program.

The assessment process:

• Principal Investigators/Lab Managers are notified of a pending assessment approximately 2 weeks in advance.  The assigned EH&S staff professional will negotiate a date and time for the assessment which should take no longer that 1.5 hours.
• Laboratory preparations prior to the assessment:
  • Biosafety Protocols
  • Chemical Safety Protocols
  • Personal Protective Equipment (PPE) assessment/training form
  • Hazard Assessment profiles for each laboratory worker assigned
  • Completed monthly eyewash inspection records
  • List of any questions or concerns to be addressed with EH&S
• The assessment encompasses a broad range of safety, health and environmental issues.  The Laboratory Assessment Checklist serves as the steering document for the assessment and will be referenced in all future discussions with the laboratory.
• EH&S maintains a web based system for the Lab Assessment program.  Results of the assessment will be provided by email and corrective action can be reported online.

C ompanion Resources:

LABORATORY FACILITIES AND EQUIPMENT

Research laboratory facilities are by nature complex and costly and have architectural, ventilation, environmental control, configuration and fire/safety requirements not found in others types of construction.  These facilities require the combined efforts of the Principal Investigator and laboratory staff, Engineering, Environmental Services and Environmental Health and Safety to provide a safe, functional and cost effective workplace for the conduct of research activities.

Laboratory supervisors or managers form the “primary line of defense” in terms of ensuring facility maintenance and safety standards are sustained.  “Staying observant” guidelines for principal investigators and laboratory supervisors:

• Keep aisles and exits free from obstruction
• Check the proximity of flammable materials to any potential ignition sources.  Open flames and devices that may produce sparks should not be near flammable chemicals (check fume hoods).
• Check equipment safety devices and emergency shut off switches for proper operation.  In some cases, the OSHA Lockout/Tagout (control of hazardous energy) regulations may apply when working on equipment (contact EH&S).
• Keep water in drain traps, particularly for floor drains or sinks that are not used regularly.
• Check for frayed electrical connections, use of extension cords (not allowed) and circuit breaker integrity.
• Ensure that plastic and/or rubber hose connections are secure.  Laboratory flooding can lead to extensive damage, research interruptions and unsafe conditions.
• Make certain that compressed gas cylinders are secured well and will not move if inadvertently jolted.
• Report any “out of the ordinary” conditions to Engineering.  File a hazard report with EH[dab1] &S.  Follow up until the problem situation is corrected or alleviated.

The above check points are not comprehensive. Supervisors are encouraged to develop a specific checklist which applies to the lab and associated equipment.  This may include reviewing operational manuals for lab equipment and systems.

Common or Shared Rooms and Equipment/Resources

The sharing of common laboratory space and equipment is a standard practice within departments and between Principal Investigators.  Shared facilities include storage units such as refrigerators, freezers, cold rooms, stock rooms, flammable liquids cabinets and autoclaves.   

When facilities, rooms or equipment are shared, accountability should be established to ensure:

• Periodic and corrective maintenance actions are performed.
• Regular cleaning is executed.
• Chemical segregation is maintained.
• Hazardous waste is not accumulated (stored) in common rooms.
• Unwanted materials and equipment is removed on a periodic basis.

C ompanion Resources:

Chemical and Equipment Procurement

 Some chemicals and equipment have inherent safety hazards that require special safety controls.  EH&S provides consultation services for Principal Investigators and lab managers prior to the purchase of certain materials and equipment, such as:

• Biological agents
• Biosafety cabinets
• Chemicals: lethal toxicants, unstable and reactive materials
• Chemical storage cabinets
• Fire extinguishers
• Fume hoods
• Gas storage cabinets
• Hazardous and toxic gases
• Laminar flow hoods
• Laser equipment (excluding laser pointers)
• Radioactive isotopes
• Refrigerants and ozone-depleting substances
• Refrigerators and freezers for flammable liquid storage
• Respiratory protective equipment
• X-ray equipment

Before receiving a hazardous material, information on proper handling, storage, and disposal must be understood. It is the responsibility of the Principal Investigator to ensure that the facilities in which the substance will be handled are adequate and that those who will handle the substance have received the proper training. The MSDS should be reviewed prior to using the substance. An EH&S subject matter expert may also be consulted for guidance. It is also important to limit chemical purchases to the amount actually needed.