CHEMICAL HEALTH RISK ASSESSMENT AT PRIVATE

MEDICAL LABORATORY

a
ay
al
MOHAMMAD FAUZAN BIN MOHAMMAD
ROHMATULLAH
M
of
ty
r si
ve

FACULTY OF ENGINEERING
UNIVERSITY OF MALAYA
ni

KUALA LUMPUR
U

2018
 CHEMICAL HEALTH RISK ASSESSMENT AT
PRIVATE MEDICAL LABORATORY

a
ay
MOHAMMAD FAUZAN BIN MOHAMMAD

al
ROHMATULLAH

M
of
RESEARCH REPORT SUBMITTED IN PARTIAL
FULFILMENT OF THE REQUIREMENTS FOR THE
ty

DEGREE OF MASTER OF ENGINEERING

r si
ve

FACULTY OF ENGINEERING
UNIVERSITY OF MALAYA
KUALA LUMPUR
ni
U

2018
 UNIVERSITY OF MALAYA
ORIGINAL LITERARY WORK DECLARATION

Name of Candidate: Mohammad Fauzan Bin Mohammad Rohmatullah

Matric No: KGJ130036
Name of Degree: Master of Engineering (Safety, Health and
Environment Title of Project Paper/Research Report/Dissertation/Thesis
(“this Work”): Chemical Health Risk Assessment at Private Medical
Laboratory

a
ay
Field of Study:

I do solemnly and sincerely declare that:

al
(1) I am the sole author/writer of this Work;
(2) This Work is original;
M
(3) Any use of any work in which copyright exists was done by way of fair dealing
and for permitted purposes and any excerpt or extract from, or reference to or
reproduction of any copyright work has been disclosed expressly and
of
sufficiently and the title of the Work and its authorship have been
acknowledged in this Work;
(4) I do not have any actual knowledge nor do I ought reasonably to know that the
ty

making of this work constitutes an infringement of any copyright work;

(5) I hereby assign all and every rights in the copyright to this Work to the
University of Malaya (“UM”), who henceforth shall be owner of the copyright
si

in this Work and that any reproduction or use in any form or by any means
whatsoever is prohibited without the written consent of UM having been first
r

had and obtained;

ve

(6) I am fully aware that if in the course of making this Work I have infringed any
copyright whether intentionally or otherwise, I may be subject to legal action
or any other action as may be determined by UM.
ni

Candidate’s Signature Date:

U

Subscribed and solemnly declared before,

Witness’s Signature Date:

Name:
Designation:

ii
 ABSTRACT

The use of chemicals in laboratories need proper safety management to protect staff from

chemical health risk during performing their work. The purpose of this study is to identify

and evaluate the level of exposure of chemicals towards staffs which working in the

laboratory. A private medical laboratory was selected and chemical health risk assessment

a
(CHRA) was conducted. The CHRA was carried out according to guidelines from DOSH

ay
under Use and Standard of Exposure of Chemicals Hazardous to Health (USECHH), 2000

al
Regulations. The assessment involving site visit, observation on handling chemicals by

laboratory staff, reviewing lab manual and other relevant documents. Overall, 10 work
M
units with total 108 chemicals managed to be assessed. Result found that risk of chemicals
of
are significant either C2 or C3. There are four work units were marked C2 by having

significant risk and adequately controlled. The other six work units fall under C3 which
ty

having significant risk but inadequately controlled. Based on the conclusion, CHRA were
si

conducted to reduce the risks of chemical exposure among laboratory staff. This study
r

can be useful to implement CHRA program in laboratories to assess the risk of chemical
ve

exposure and required control measures for the protection of laboratory staff.
ni
U

iii
 ABSTRAK

Penggunaan bahan kimia dalam makmal memerlukan pengurusan keselamatan yang

betul untuk melindungi pekerja dari risiko kesihatan kimia semasa melaksanakan kerja

mereka. Tujuan kajian ini adalah untuk mengenal pasti dan menilai tahap pendedahan

bahan kimia terhadap kakitangan yang bekerja di makmal. Sebuah makmal perubatan

swasta telah dipilih dan penilaian risiko kesihatan kimia (CHRA) telah dijalankan. CHRA

a
telah dijalankan mengikut garis panduan dari DOSH di bawah Penggunaan dan Standard

ay
Pendedahan Bahan Kimia Berbahaya kepada Kesihatan (USECHH), Peraturan 2000.

Penilaian yang melibatkan lawatan tapak, pemerhatian mengendalikan bahan kimia oleh

al
kakitangan makmal, mengkaji manual makmal dan dokumen lain yang berkaitan. Secara
M
keseluruhan, 10 unit kerja dengan jumlah 108 bahan kimia berjaya ditaksir. Keputusan

mendapati bahawa risiko bahan kimia adalah penting sama ada C2 atau C3. Terdapat
of
empat unit kerja ditandakan C2 dengan mempunyai risiko yang signifikan dan dikawal
ty

secukupnya. Enam unit kerja yang lain jatuh di bawah C3 yang mempunyai risiko ketara
si

tetapi tidak terkawal. Berdasarkan kesimpulannya, CHRA telah dijalankan untuk

mengurangkan risiko pendedahan kimia di kalangan kakitangan makmal. Kajian ini

r
ve

berguna untuk melaksanakan program CHRA di makmal untuk menilai risiko

pendedahan kimia dan langkah-langkah kawalan yang diperlukan untuk perlindungan

ni

kakitangan makmal.
U

iv
 ACKNOWLEDGEMENTS

Alhamdulillah, praise be to Allah for giving me this chance, strength and patience to

accomplish my research work finally. I would like to express my feeling and sincere

gratitude to the several people who continuously supported me and contributed valuable

assistance in the preparation and completion of my research work.

a
First and foremost, my sincere appreciation to my supervisor, Dr Tan Chee Keong for his

ay
sincerity, assistance, support and advice. I am grateful to his unlimited guidance and

encouragement throughout this journey and without him, this research would not be

al
complete.
M
A deeply grateful and unconditional love to my family especially to my parent and
of
siblings for their constant support and prayer. May Allah grant to all of you His blessing
ty

for everything you have done to help me to this point.

i
rs

Last but not the least, I wish to express my warm truthful to my wife for his continues
ve

support, listening and encouraging me to do my master. Without her this work would not

be completed. I never ever forget also to say thanks to my lovely and sweet daughter.
ni
U

v
 TABLE OF CONTENTS

Abstract……………………………………………………………………………...iii

Abstrak…………………………………………………………………………….....iv

Acknowledgements……………………………………………………………….......v

Table of Contents.........................................................................................................vi

List of Tables.............................................................................................................viii

a
List of Symbols and Abbreviations..............................................................................ix

ay
CHAPTER 1: INTRODUCTION..............................................................................1

CHAPTER 2: LITERATURE REVIEW..................................................................5

al
2.1 Chemical Hazard Exposure....................................................................................5
M
2.2 Permissible Exposure Limit (PEL)........................................................................6
of
2.3 Chemical Health Risk Assessment.........................................................................7

2.4 Chemical Management in Laboratory....................................................................8

ty

2.4.1 Chemical Register......................................................................................8

i
rs

2.4.2 Chemical Inventory...................................................................................9

ve

2.4.3 Chemical Storage.......................................................................................9

2.5 Material Safety Data Sheet...................................................................................10

ni

CHAPTER 3: METHODOLOGY...........................................................................13
U

3.1 Deciding the Assessor..........................................................................................13

3.2 Gather Information..............................................................................................14

3.3 Divide into Work Unit..........................................................................................14

3.4 Determine Degree of Hazards..............................................................................14

3.4.1 Hazard Information..................................................................................15

3.4.2 Hazard Rating Determination..................................................................15

vi
3.5 Evaluate Exposure...............................................................................................18

3.5.1 Frequency of Exposure............................................................................18

3.5.2 Duration of Exposure...............................................................................18

3.5.3 Magnitude of Exposure............................................................................19

3.6 Adequacy of Control Measures............................................................................21

3.7 Conclusion of the Assessment..............................................................................22

3.8 Actions to be Taken..............................................................................................23

a
CHAPTER 4: RESULT.................................................................................................24

ay
4.1 Work Unit Description.........................................................................................24

al
4.2 Hazard Rating......................................................................................................36

4.3 M
Exposure Rating...................................................................................................45

4.4 Adequacy of Existing Control..............................................................................51

of
4.5 Conclusion of the Assessment..............................................................................51
ty

CHAPTER 5: DISCUSSION........................................................................................59
i

5.1 Conclusion of Assessment...................................................................................59

rs

5.2 Technical Measures.............................................................................................59

ve

5.2.1 Elimination / Substitution........................................................................59

ni

5.2.2 Isolation / Enclosure................................................................................59

U

5.2.3 Ventilation...............................................................................................60

5.2.4 Work Practice / System of Work..............................................................61

5.2.5 Personal Protection..................................................................................62

5.3 Action to Control.................................................................................................62

CHAPTER 6: CONCLUSION......................................................................................64

REFERENCES..............................................................................................................65

vii
 LIST OF TABLES

Table 3.1: Hazard Rating Based on Risk Phrase ............................................................ 17

Table 3.2: Frequency Rating ........................................................................................... 18

Table 3.3: Duration Rating ............................................................................................. 19

Table 3.4: Degree of Chemical Release .......................................................................... 19

Table 3.5: Degree of Chemical Absorbed ....................................................................... 20

a
Table 3.6: Magnitude Rating .......................................................................................... 20

ay
Table 3.7: Exposure Rating............................................................................................. 21

Table 3.8: Risk Matrix .................................................................................................... 22

al
Table 3.9: Risk Conclusion ............................................................................................. 23
M
Table 4.1: Number of Work Unit and Total of Chemicals ............................................. 24
of
Table 4.2: Biochemistry .................................................................................................. 25

Table 4.3: Haematology .................................................................................................. 26

ty

Table 4.4: Specimen Grossing ........................................................................................ 26

i
rs

Table 4.5: Specimen Processing and Routine Staining .................................................. 28

ve

Table 4.6: Specimen Processing and Special Stain ........................................................ 29

Table 4.7: Immunohistochemistry Staining .................................................................... 30

ni

Table 4.8: Surepath Test ................................................................................................. 31

U

Table 4.9: Non Gynae Sample ........................................................................................ 32

Table 4.10: Cell Block Sample ....................................................................................... 33

Table 4.11: Bacteriology ................................................................................................. 35

viii
 LIST OF SYMBOLS AND ABBREVIATIONS

ACH : Air change per hour

ACGIH : American Conference of Governmental Industrial Hygienist

American Society of Heating, Refrigerating and Air-Conditioning

ASHRAE :
Engineers

CHRA : Chemical Health Risk Assessment

a
DOSH : Department of Occupational Safety and Health

ay
ER : Exposure Rating

GV : General Ventilation

al
GHS : Globally Harmonized System

HR : Hazard Rating
M
LC50 : Lethal Concentration, 50%
of
LD50 : Lethal Dose, 50%
ty

LEV : Local Exhaust Ventilation

i

MR : Magnitude Rating
rs

OSHA : Occupational Safety and Health Act

ve

PEL : Permissible Exposure Limit

ni

PPE : Personal Protective Equipment

RR : Risk Rating
U

SDS : Safety Data Sheet

SK : Skin Notation

TWA : Time-Weighted-Average

TD : Total Duration of Exposure

USECHH : Use and Standard of Exposure of Chemicals Hazardous to Health

ix
 CHAPTER 1

1.0 INTRODUCTION

Laboratory is an area that equipped with various instruments, equipment and chemicals or

reagents for performing experimental works, research activities and investigative procedures.

Medical laboratory is a part of laboratory that provides a facility to perform a test on clinical

a
specimens in order to obtain information about the health of a patient as pertaining to the

ay
diagnosis, treatment, and prevention of disease. There are various of biomedical instruments,

equipment, materials and chemicals for performing different laboratory investigative activities

al
by using biological specimens such as whole blood, serum, plasma, urine and body tissues.

M
Medical laboratory is a complex field embracing a number of different disciplines such as

Microbiology, Hematology, Urinalysis, Serology, Immunology, Molecular, Cytopathology,

of
Histopathology and others. People who involve or working in medical laboratory known as
ity

pathologist, medical laboratory technologist (MLT), phlebotomist, laboratory manager,

dispatch, general worker and other support staff. These people are exposed to chemical directly
rs

or indirectly.
ve

Laboratory staff have high tendency of susceptible to chemical hazards because they handle
ni

the chemical directly in order to perform laboratory tests. According to OSHA-US Department
U

of Labor, hazardous chemical can be present as health threats or in physical form to workers

whether in academic laboratories, industrial and clinical. The health effects are toxins,

carnogenics, corrosives, irritants, sensitizers, hepatotoxins, neurotoxins, nephrotoxins as well

as agents that act to damage the lungs or on the hematopoietic systems, eyes, skin or mucous

membranes (OSHA, 2002). There are several ways of for hazardous chemicals enter through

the body. Basically, there are 4 ways of hazardous chemicals may enter the body. The chemical
1
may enter through inhalation, skin absorption, ingestion and injection. In a laboratory, the

primary entry is through inhalation and dermal contact (CEOSH, 2013). The effects of

exposure to a chemical are dependent on many factors. The dose is the amount of a medicine

or drugs that enter the body. The dosage depends on the concentration of the chemical and the

frequency and duration of the exposure that person received. To determine the dosage, all

possibility routes of exposure must be considered. Besides the quantity of the dose itself, the

a
resultant of exposure is related to the factor of (1) the way the chemical enters the body, (2)

ay
the physical properties of the chemical, and (3) the susceptibility of the individual receiving

the dose.

al
M
Since the employees and laboratory staff may expose to various hazardous chemicals, their

safety and health of individuals involved must always be safeguarded especially laboratory
of
staff. This is because they are continuously exposed to hazardous chemicals. It is the general
ity

responsibility of an employer under the Occupational Safety and Health Act 1994 (514 Act),

whereby the employer is required to provide a safe working environment for his employees
rs

and other related individuals (Husin, Mohamad, Abdullah, & Anuar, 2012). To provide safe
ve

work environment, the hierarchy for control measures need to be assessed and applied (OSHA,

2003). Thus, to manage the chemical hazard in laboratory potential hazard must be identified
ni

and quantified the risk. An effective engineering controls can reduce exposure to acceptable
U

levels and at minimum intensity or concentration which can eliminate the exposure. The

hierarchy in controlling exposure: elimination, substitution, engineering, administrative, and

personal protective equipment (PPE). The best controls of all are eliminating the hazard

altogether or substituting a less hazardous chemical or process. Engineering controls, including

enclosure, redesign, automation, ventilation, or robotics, are also effective and reliable

methods to eliminate hazardous exposure (Burton, 1997).

2
In Malaysia, the main statute protecting safety and health of workers at the workplace is

Occupational Safety and Health Act 1994 (Act 514). The Act provides legal frameworks to

ensure safety, health and well-being among all employees and to protect others from any harm

to safety or health in connection with the activities of others in the workplace. The provision

of the Occupational Safety and Health Act 1994 is derived from a self-regulatory philosophy

whose primary responsibility is to ensure the safety and health for those who make the risks

a
and work at risk. With the aim of protecting workers from hazardous chemical exposure and

ay
their risk, Chemical Health Risk Assessment (CHRA) needs to be carried out.

al
Under Use and Standard of Exposure of Chemicals Hazardous to Health (USECHH)

M
Regulations 2000, under section 26 Part VIII Monitoring of Exposure at the Workplace which

required for employers to perform CHRA assessment whenever involving any duty that related
of
to the handling, use, storage or transportation of chemicals hazardous to health in the
ity

workplace. The purpose of the assessment is to allow identification and evaluation of risks

involved and the level of exposure to chemicals handled at the laboratory (Husin et al., 2012).
rs

An employer has the obligation to stop and not to perform any work or activity, if any of their
ve

employees was exposed or possible exposed to any hazardous chemical that are harmful to the

employee’s health. Otherwise, in order to perform the activities or work, an employer shall
ni

perform a written risk assessment, affected by the chemical to the employee’s health.
U

It has been always the responsibility of the employer to ensure a healthy and safe working

environment for employees and others. Thus, in this study the researcher want to conduct a

Chemical Health Risk Assessment at his workplace in one of private medical laboratory which

located in Kuala Lumpur. The results of the study may be beneficial to the company so as to

3
protect employees from the adverse health effects of chemicals and also to comply with the

Occupational Safety and Health (Use and Standard Exposure of Chemical Hazardous to

Health) Regulations 2000.

The purpose of this study are

1) To identify hazard posed by chemical substance used, stored, handled or transported

a
within the place of work.

ay
2) To evaluate degree of exposure of employees to hazardous chemicals, either through

inhalation, skin absorption or ingestion.

al
3) To evaluate the adequacy of existing control measures.

M
4) To conclude the significant of the health risk posed by the hazardous chemicals.

5) To recommend further the appropriate control measures to prevent or reduce risks.

of
ity
rs
ve
ni
U

4
 CHAPTER 2

2.0 LITERATURE REVIEW

2.1 Chemical Hazard Exposure

Chemical is one of the hazards which seriously highlight the effect of its exposure either

through a short term or a long term. Each individual may have different effects when being

exposed to the same chemical type and quantity. These different effects are due to various

a
factors such as gender, age, genetic and other health condition. Under a low dose chemical

ay
exposure, there might be no significant effects shown at all in a short duration of time. While

al
under high doses of exposure to the same chemical, if there is no observable effects shown it

can be considered as a no observable adverse effect level (NOAEL). This is a stage where

M
certain chemicals are considered to have no significant increase in statistics significantly by
of
comparing both exposed populations and controlled populations. However NOAEL for each

particular chemical might not be perfectly risk free. This is due to the unknown long term effect
ity

that might appear later. Hence, there is ongoing research to gain new findings to be discovered

in the future (Huntzinger & Eatmon, 2009).

rs
ve

In medical laboratory, Formaldehyde is primarily used as a tissue preservative. It is usually

ni

found in a solution called formalin, which is 37% to 50% formaldehyde in water with 6-15%
U

alcohol stabilizer. Laboratory staffs are at risk of formaldehyde. Skin inhalation and absorption

is the primary route of exposure. Formaldehyde is a confirmed human carcinogen (Charney,

2010). Skin exposure can cause sensitization, which can lead to dermatitis upon contact with

small amounts of formaldehyde or formalin. Exposure to Formaldehyde can cause other health

effects also such as irritation and burning of nose and throat, irritation of mucous membranes,

burning of the skin, coughing, and vomiting. Formaldehyde is also classified as highly
5
flammable chemical. The OSHA PEL is 0.75 ppm with a 15-minute ceiling of 2 ppm, and the

ACGIH TLV-Ceiling limit is 0.3 ppm. NIOSH recommends a TWA of 0.016 ppm and a ceiling

of 0.1 ppm.

Ben Owen has reviewed on requirements before the hazardous chemicals can be used in

laboratories by the University requires approval for highly dangerous chemical. Historically,

a
usage of chemicals in the field of research are not restricted from high-level expertise to low-

ay
level skills researchers as they are qualified and have the right to use chemicals. Therefore, the

wisdom of chemical safety is generally not an important concern. Inconsistency in regulations

al
that result in strict regulatory and research requirements rather than the severity and potential

M
hazards posed by the chemicals (Owens, 2014)
of
2.2 Permissible Exposure limit (PEL)
ity

An exposure limits are the concentration of chemicals in the workplace that most workers may

be repeatedly exposed without adverse health effects. Permissible exposure limits are
rs

guidelines for determining the toxicity of the substance. There are many organizations which
ve

published PEL values based on past experience and laboratory testing data. Threshold limit

values (TLVs) are exposure guidelines developed by the American Conference of

ni

Governmental Industrial Hygienists (ACGIH) (M. A. Jayjock, 2001). Permissible exposure

U

limits (PELs) are legal exposure limit in the United States, from the Occupational Safety and

Health Administration (OSHA) and Workplace Environmental Exposure Level (WEEL) from

the American Industrial Hygienist Association (AIHA) are some well-recognized exposure

guidelines in industrial hygiene applications. However, there are three different types of

exposure limits in common use:

6
1) Time-weighted average (TWA) exposure limit is the time-weighted average concentration

of a chemical in air for a normal 8-hour work day to which nearly all workers may be exposed

day after day without harmful effects.

2) Short-term exposure limit (STEL) is the average concentration to which workers can be

exposed for a short period (15 minutes) without experiencing irritation, long-term or

irreversible tissue damage.

a
3) Ceiling exposure limit (C) is the concentration which should not be exceeded at any time.

ay
For example, Formaldehyde is classified as highly flammable chemical. The OSHA PEL is

al
0.75 ppm with a 15-minute ceiling of 2 ppm, and the ACGIH TLV-Ceiling limit is 0.3 ppm.

M
NIOSH recommends a TWA of 0.016 ppm and a ceiling of 0.1 ppm (Charney, 2010).
of
2.3 Chemical Health Risk Assessment
ity

There are many guidelines available to evaluate hazards and assessing risks in the workplace.

The purposes of these guidelines is to reduce all chemical exposures and risks to health. Each
rs

chemical in available in the laboratory not all are hazardous to health. Therefore, not all labs
ve

are potentially harmful to health. However, general precautions for handling all chemicals in

laboratory should be adopted. Other than these general guidelines for chemicals that are used
ni

frequently or are principally hazardous specific guidelines should be adopted (OSHA, 2013).
U

A study of chemical health risk assessment was carried out on chemical usage at the Chemical

and Biochemical Engineering Laboratory. The purpose of the assessment is to identify and

evaluate the risks involved and the level of exposure to chemicals handled at the labs. Besides

that, it is also for evaluation on the sufficiency of the current control measures practiced by the

staff and students of the department. This detailed and qualitative assessment is based on
7
observations made of the staff while handling chemicals and reviews of the work procedures

and manual as well as other related documents and records. Prevention and mitigation

measures by a proactive approach were taken to minimize health risks during the learning and

research process (Husin et al., 2012).

2.4 Chemical Management in Laboratory

a
Proper chemical management and training are essential to make laboratory staffs and

ay
employees aware of potential hazards related to chemical use. Improper chemical management

in laboratories can lead to threats to laboratory staffs (Mogopodi, Paphane, & Petros, 2015).

al
Eguna et. al. (2011) in its review of the management of chemical laboratories in developing

M
countries has noted the chemical risks that have jeopardized academic institutions because of

budget constraints. Since an explosion incident occurred at Texas Tech University's Chemical
of
Lab in 2010 the appropriate review was required and required institutional approval for the use
ity

of chemicals in research laboratories (Eguna, Suico, & Lim, 2011). This has been disclosed by

Robert Emery (2013) in his paper on the criteria for avoiding high risk chemicals that have
rs

been used have posed a real challenge to make work safer because the dispute articulated the
ve

value of prevention by all laboratory staffs such as awareness and compliance with security

requirements and practices (Emery, 2013). Chemical management should be implemented in

ni

laboratories in order to minimize the exposure to chemicals and control the hazards, these
U

include chemical register, chemical storage and chemical inventory.

2.4.1 Chemical Register

The chemical list is required by all employers to identify and register all hazardous chemicals

to the health of the workplace. This requirement is stated under USECHH Rules, 2000. The

purpose of registering chemicals is to ensure that laboratory personnel are aware of the
8
presence of hazardous chemicals in their laboratory and information on health risks and

preventive measures against them. This chemical list is a tool for assessors to obtain

information for risk assessment (HSW, 2015).

2.4.2 Chemical Inventory

In order to ensure laboratory a safe place for working, chemical inventory have to be

a
maintained and updated (Richards-Babb, Bishoff, Carver, Fisher, & Robertson-Honecker,

ay
2010). Bynam et al. suggested that chemical inventories in the lab can reduce the risk of

laboratory personnel from hazardous chemicals. This list allows the decision to be made in

al
determining the required chemicals and also to dispose of unnecessary chemicals (Bynam et

M
al., 2009). Foster (2003) stated that chemical inventory is part of nine elements of an effective

laboratory safety. Foster has also identified the management of hazardous materials as the most
of
important aspect and emphasizes it as the principle of laboratory safety management at higher
ity

institutions (Foster, 2003).

rs

2.4.3 Chemical Storage

ve

Chemicals should be segregated and stored in the category of hazards and compatibility to

prevent laboratory staffs in facing these chemical risks. Moreover, when buying chemicals, it
ni

is best to buy according to the quantity requested to avoid the harmful effects of storing excess
U

chemicals, saving space in storage rooms and also minimizing waste to the lowest level.

Additionally, storing chemicals requires a good understanding about the chemical hazards.

Chemical spills or sparks can create fires, toxic fumes and explosions (Foster, 2004).

Becker and Elston (2004) conducted an evaluation for storing hazardous chemicals in

secondary schools. They concluded that the chemical storages in these schools were improper
9
and the high percentages of chemical reagents increase the severity of the risk through

accidental reactions (Becker & Elston, 2004).

It is the responsibility of the teachers and the supervisors to teach the student about proper

chemical storage, as well as to enhance their safety knowledge (Sarquis, 2003). Cournoyer et

al. (2005) suggested to use the chemical inventory software programs as an easy way to

a
develop chemical storage. This software able to organize the chemicals according to their

ay
compatibility and minimize the hazard (Cournoyer, Maestas, Porterfield, & Spink, 2005).

However, the efficiency of this software depends on the accuracy of the input data.

al
Furthermore, Gibbs (2005) reported that such systems can organize hazard reports and offer

M
MSDSs, besides it can also show the chemical expiration date (Gibbs, 2005).
of
2.5 Material Safety Data Sheet (MSDS)
ity

A Material Safety Data Sheet (MSDS) is a document that contains information on the potential

health effects of exposure as well as information concerning safe use, handling, and storage.
rs

This is an important starting point for complete healthcare development and a safe program. It
ve

contains hazard assessments regarding the use, storage, handling and emergency procedures

associated with the substance. The MSDS also contains more information about the material
ni

than the material label (Greenberg, Cone, & Roberts, 1996).

U

The MSDS must consists of physical and chemical characteristics of the product, precautions

for a safe product handling, and health hazards from exposure to the product. However, as

stated by Foster, the American National Standard Institute (ANSI) established 16 standard

sections of MSDS format (Foster, 2007):

1. Material identification
10
2. Composition

3. Hazards identification

4. First aid measures

5. Firefighting measure

6. Accidental release measures

7. Handling and storage

a
8. Exposure controls and personal protection

ay
9. Physical and chemical properties

10. Stability and reactivity

al
11. Toxicological information

M
12. Ecological information

13. Disposal consideration

of
14. Transport information
ity

15. Regulatory information

16. Additional information

rs
ve

Phillips conducts studies on employees understanding and acceptance of MSDS. The results

have shown that most employees report that MSDS is acceptable and accessible, while others
ni

do not agree that MSDS is easy to read and understand. Furthermore, they were not asked to
U

see it while working with chemicals (Phillips et al., 1999). Bernstein have stated four major

limitations of MSDSs (Bernstein, 2002):

1. Elimination of basic information regarding the general chemical names and formulas

of hazardous agents.

2. Omission of the listing of potential respiratory and skin sensitizing agents that are

known to induce reactions through a specific immune response.

11
3. Failure to update current permissible exposure levels (PELs) for many agents that are

higher than the PELs set by OSHA in 1989.

4. Failure to require documented clinical information regarding specific occupational

lung diseases (occupational asthma) associated with a specific agent is also a major

limitation.

a
ay
al
M
of
ity
rs
ve
ni
U

12
 CHAPTER 3

3.0 METHODOLOGY

Chemical health risk assessment is carried out according to Manual Assessment of the Health

Arising from the Use of Hazardous Chemicals in the Workplace, 2nd edition. This guideline

was outlined by Department of Occupational Safety and Health (DOSH). The procedures in

carrying out a CHRA is given in Appendix 3, which consists of ten steps (DOSH, 2000).

a
Step 1: Deciding the assessor

ay
Step 2: Gather information about chemicals, work & work practices

Step 3: Divide into work units

al
Step 4: Determine degree of hazards

M
Step 5: Evaluate exposure

Step 6: Assess adequacy of control measures

of
Step 7: Conclude the assessment
ity

Step 8: Identify actions to be taken

Step 9: Reporting the assessment

rs

Step 10: Review assessment

ve

In this study, the assessment is conducted until Step 8 because Step 9 and Step 10 will involve

follow up action to employer.

ni
U

3.1 Deciding the Assessor

In order to comply with the USECHH Regulations 2000, the appointed assessor must be

registered with the Director General of Occupational Safety and Health, Malaysia. However,

this study will not be assessed by any registered CHRA assessor. The researcher will conduct

the assessment with his knowledge and guideline of CHRA manual from DOSH.

13
3.2 Gather Information

For this step, all chemicals hazardous to health found in the workplace need to be identified

and information about the work and work practices involving chemicals hazardous to health

will be collected. The assessment begins with the collection of the following information:

1. Chemical hazardous to health used or released in the workplace

a
2. Employees at risk

ay
3. Control equipment design parameter and maintenance

4. Monitoring record

al
M
3.3 Divide into work unit

Categorisation of a work unit is based on the two basic requirements:

of
a) Work similarity

Workers in the work unit must perform similar tasks. ‘Similar tasks’ means that the
ity

workers are having similar potential for exposure; and

rs

b) Similarity with respect to the hazardous agent

ve

Workers using or are exposed to the same chemical hazardous to health.

ni

3.4 Determine degree of hazards

U

Hazard rating is used to prioritize hazards based on the potential health effects of chemical.

The hazard is assessed on a scale of 1 to 5 with a rating of 1 that implies not hazardous and a

rating of 5 implies the most hazardous to health.

14
3.4.1 Hazard Information

All the hazardous chemicals were identified through the site visit, review of the chemical list

and chemical register.

The degree of Hazards is based on the Chemical Safety Data Sheet (CSDS), Material Safety

Data Sheet (MSDS), Hazard Classification Manual by DOSH and other reliable internet

source.

a
ay
The main information from the CSDS/MSDS derived is the chemical constituents of the

al
mixtures. The hazard classifications area derived base on the Hazards Classification Manual

by DOSH. If the classification by the CSDS and MSDS is less hazardous than the manual;

M
cross referenced through the internet will be conducted to ascertain the validity of the
of
conclusions. The manufacturer will also be contacted to gain access on the evidence of such

conclusion.
ity
rs

3.4.2 Hazard Rating Determination

ve

Based on these data, the hazard of each chemical can be evaluated and assigned a hazard rating.

The procedure to assign the hazard rating to the chemical is as follows:

ni

1. Obtained information on the hazard categories, hazard classification and risk phrases
U

for the chemical substance or preparation.

2. Used Table 3.1 to get hazard rating based on the hazard classification or hazard

categories, or risk phrases;

3. List the hazard ratings obtained in descending order;

4. Assign a single hazard rating based on the greatest degree of hazard from Group 1

hazard categories: -
15
 Very toxic R26-28, 39, 45(1), 46(1), 47(1), 49(1)

Toxic R23-25,39, 48, 45(2), 46(2), 47(2), 49(2)

Harmful R20-22, 40, 40(3), 40(M2), 48,

Respiratory sensitizer R42

Respiratory irritant R37

5. Assign an “sk” notation for those chemicals in Group 2 hazard categories: -

a
Corrosive to skin/eye R34, 35

ay
Skin and eye irritants R41, 38, 36

6. For a chemical substance or preparation that fall only under Group 2 and do not fall

al
into Group 1, the hazard rating assigned is to be based on Group 2

The risk phrases used in Table 3.1 are:

M
of
Acute effects:

Acute lethal effects (R20 to 28)

ity

Non-lethal irreversible effects after single exposure (R39, 40)

rs

Corrosive (R34, R35)

ve

Irritant (R36 to 38, R41)

ni

Sensitizer (R42, R43)

U

Chronic effects:

Severe effects after repeated or prolonged exposure (R48)

Carcinogen (R40, R45, R49)

Mutagen (R46, R40)

Reproductive hazards (R60 to 64)

16
 Teratogen (R47)

Table 3.1 Hazard Rating Based on Risk Phrase

ROUTES OF EXPOSURE
EFFECT ACUTE DERMAL NOT HAZARD
INH. ING.
/CHRONIC SPECIFIED RATING
SKIN EYE
(HR)
Very Toxic Acute R26 R27 R28 R39 5

a
Chronic - - - -

ay
Toxic Acute R23 R24 R25 R39 4
Chronic - - - R48, R39

al
Harmful Acute R20 R21 R22 R40 3

M
Chronic - - - R48, R40
Corrosive Acute R35 4
R34 3
of
Irritant Acute R37 - R41 3
- R38 R36 2
ity

Sensitizing Acute R42 - R41 3

- R43 2
rs

Carcinogenic Chronic R49(1) R45(1) 5

R49(2) R45(2) 4
ve

- R40(3) 3
Mutagenic R46(1) 5
ni

R46(2) 4
R40(M2) 3
U

Teratogenic R47(1) 5
R47(2) 4

17
3.5 Evaluate Exposure

For this step, we will assess the potential of chemicals enter the body through various routes

of entry or possibility for contact with eye, skin or respiratory. The exposure rating can be

determined according to these 3 parameters:

a) Frequency of exposure, F

b) Duration of exposure, D

a
c) Intensity or magnitude of exposure, M

ay
3.5.1 Frequency of Exposure, F

al
The frequency of exposure is defined as the number of times exposed to chemical that have a

M
significant effect on the degree of exposure. Frequency rating is used and determined from

Table 3.2.
of
ity

Table 3.2 Frequency rating

Rating Description Definition

rs

5 Frequent Potential exposure one or more time per shift or per day
ve

4 Probable Exposure greater than one time per week

3 Occasional Exposure greater than one time per month
ni

2 Remote Exposure greater than one time per year

1 Improbable Exposure left than one time per year
U

3.5.2 Duration of Exposure

The exposure duration is the product of the number of exposure and the average duration of

each exposure. The duration of exposure can be calculated using formula below:

Total exposure per week, TD

= (Number of exposure per week) x (Average duration of each exposure)

18
 Table 3.3 Duration rating

Rating Total Duration of Exposure

% work hour Duration per 8 hours shift or per 40 hours week
5 >87.5 > 7 hrs/ shift or > 35 hours/ week
4 50 – 87.5 4 to 7 hrs/ shift or 20 to 35 hours/ week
3 25 – 50 2 to 4 hrs/ shift or 10 to 20 hours/ week
2 12.5 – 25 1 to 2 hrs/ shift or 5 to 10 hours/ week
1 <12.5 < 1 hr/ 8 hr shift or < 5 hours/ week

a
ay
3.5.3 Magnitude of Exposure

al
Magnitude of exposure rating will determines degree of chemical release or presence and also

degree of chemical absorb or contact.

M
of
1) Degree of Chemical Release

Table 3.4 Degree of chemical release

ity

Degree Observation
rs

Low Low or little release into the air. No contamination of air, clothing and
work surfaces with chemicals capable of skin absorption or causing
ve

irritation or corrosion.
Moderate Moderate release of chemicals. Evidence of contamination of air, clothing
ni

and work surfaces with chemicals capable of skin absorption or causing

irritation or corrosion
U

High Substantial release of chemicals. Gross contamination of air, clothing and

work surfaces with chemicals capable of skin absorption or causing
irritation or corrosion.

19
2) Degree of Chemical Absorbed

Table 3.5 Degree of chemical absorbed

Degree Observation
Low Low breathing rate (light work).
No contamination or indication on skin or eyes
Moderate Moderate breathing rate (moderate work)
Source in close to respiratory zone

a
Capable to skin penetration

ay
High High breathing rate (heavy work).
Source within respiratory zone.

al
Damage to skin.

3) Magnitude Rating M
of
Table 3.6 Magnitude rating
ity

Degree of Release Degree of Absorption MR

Low Low 1
rs

Moderate 2
ve

High 3
Moderate Low 2
Moderate 3
ni

High 4
U

High Low 3
Moderate 4
High 5

20
4) Exposure Rating

Table 3.7 Exposure Rating

Magnitude Rating (MR)

1 2 3 4 5
1 1 2 2 2 3
Frequency Rating /
Duration Rating

2 2 2 3 3 4
3 2 3 3 4 4

a
4 2 3 4 4 5

ay
5 3 4 4 5 5

al
M
3.6 Adequacy of Control Measures

This step was conducted at the same time during the exposure evaluation by inspection,
of
checking records on control equipment and procedures including the use of personal protective

equipment (PPE). Also checked were equipment maintenance records and records of incident
ity

or accidents. The current control measures applied in the laboratory have to be assessed to
rs

ensure they are adequate or not. By observing the following factors, we can assess the adequacy
ve

of control measures:

a) Suitability
ni

b) Use
U

c) Effectiveness

d) Maintenance

21
3.7 Conclusion of the Assessment

Risk is evaluated as either “significant” or “not significant”. Significant means if the exposure

give health adverse effect. Risk rating can be calculated from the following equation:

RR = √ (HR x ER)

Risk also can be evaluated using the summarized risk matrix as shown in Table 3.8 below.

a
Table 3.8 Risk Matrix

ay
Exposure Rating (ER)
1 2 3 4 5

al
1 RR=1 RR=2 RR=2 RR=2 RR=3

M
2 RR=2 RR=2 RR=3 RR=3 RR=4
Hazard Rating

3 RR=2 RR=3 RR=3 RR=4 RR=4

4 RR=2 RR=3 RR=4 RR=4 RR=5
of
5 RR=3 RR=4 RR=4 RR=5 RR=5
ity

Risk Not Significant

Risk Significant – Category 1
rs

Risk Significant – Category 2

ve

According to the risk decision and the assessment of existing control measures, the conclusion
ni

can be made from the assessment. The conclusion, C is range from C1 to C5

U

22
 Table 3.9 Risk Conclusion

Conclusion Risk Decision

C1 Risk Not Significant Now
C2 Risk Significant but Adequately Controlled
C3 Risk Significant and Not Adequately Controlled
C4 Insufficient Information
C5 Uncertain About Exposure

a
ay
3.8 Actions to be taken

The actions to be taken can be recommended according to the risk decision obtained after the

al
assessment findings. the actions to be taken by the management in order to obtain control on

M
the hazards and risk due to exposure to chemical hazardous to health. The action recommended

will be the practicable options and decided after discussion with the management on the
of
practicability.
ity
rs
ve
ni
U

23
 CHAPTER 4

4.0 RESULT

This study was conducted at private medical laboratory which located in Kuala Lumpur. This

medical laboratory have 7 laboratory departments and 5 departments was selected to perform

chemical health risk assessment. The 5 departments are Biochemistry, Hematology,

Histopathology, Cytopathology and Microbiology. Based on the findings, there are about 108

a
total number of chemicals were assessed in this medical laboratory. The work unit is

ay
determined by the type of works. Table 4.1 below shows numbers of work unit and total of

chemical in each department.

al
M
Table 4.1 Number of Work Unit and Total of Chemicals
of
No. Laboratory Department No. of Work Unit No. of Chemicals

1 Biochemistry 1 29
ity

2 Hematology 1 13

3 Histopathology 4 45
rs

4 Cytopathology 3 15
ve

5 Microbiology 1 6
ni

4.1 Work Unit Description

U

The work units involved in the assessment are:

a) Biochemistry

b) Haematology

c) Specimen Grossing

d) Specimen Processing and Routine Staining

24
 e) Special Stain

f) Immunohistochemistry Staining

g) Surepath Test

h) Non-Gynae Sample

i) Cell Block Sample

j) Bacteriology

a
ay
Table 4.2 Biochemistry

al
Work unit name Biochemistry
Work area Biochemistry Laboratory (Level 3)

M
Work unit staffing Male: - Female: 5
Work unit shift and time Normal: 8.30 AM to 5.30 PM
of
Work unit function Performs a wide variety of different
biochemical tests for blood and other body
ity

fluids.
Task involving chemical Routine :
 Sample management – receiving
rs

 Sample processing
ve

 Equipment preparation
 Staining of slides
ni

 Clinical waste disposal

U

Non-Routine :
 Equipment cleaning, maintenance
or troubleshooting
 Goods receiving
 Chemical waste disposal

25
 Table 4.3 Haematology

Work unit name Haematology

Work area Heamatology Laboratory (Level 3)
Work unit staffing Males: - Females: 3
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function Performs routine tests of blood and full
differential counts from venous and
capillary blood samples from patients.

a
Task involving chemical Routine :

ay
 Sample management – receiving
 Sample processing

al
 Equipment preparation
 Staining of slides

M  Clinical waste disposal

of
Non-Routine :
 Equipment cleaning, maintenance
ity

or troubleshooting
 Goods receiving
rs

 Chemical waste disposal

ve
ni

Table 4.4 Specimen Grossing

Work unit name Specimen Grossing

U

Work area Histopathology Laboratory (Level 4)

Work unit staffing Male: 7 Females: 6
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function Perform grossing of tissue samples.
Task involving chemical Routine:

26
  Sample management – receiving
& registration
 Sample processing
• Grossing
• Tissue processing
• Tissue embedding
• Tissue sectioning and
fishing

a
• Slide staining
•

ay
Slide mounting
• Slide sorting and
distribution

al
 Special stain and

M
Immunohistochemistry staining
Non-Routine:

of
Frozen section session
 Chemical preparing
• Formalin
ity

• Alcohol
• Acid alcohol
rs

• Staining solution or
ve

chemical
• Tissue processor
ni

solution or chemical
• Special stain/IHC
U

solution or chemical
 Equipment cleaning, maintenance
or troubleshooting.
 Chemical Waste Disposal
 Slide, block and sample filing

27
 Table 4.5 Specimen Processing and Routine Staining

Work unit name Specimen Processing and Routine

Staining
Work area Histopathology Laboratory (Level 4)
Work unit staffing Male: 7 Females: 6
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function Specimen fixation and staining.
Task involving chemical Routine:

a
 Sample management – receiving

ay
& registration
 Sample processing

al
• Grossing
• Tissue processing

M •
•
Tissue embedding
Tissue sectioning and
of
fishing
• Slide staining
ity

• Slide mounting
• Slide sorting and
rs

distribution
 Special stain and
ve

Immunohistochemistry staining
Non-Routine:
ni

 Frozen section session

 Chemical preparing
U

• Formalin
• Alcohol
• Acid alcohol
• Staining solution or
chemical
• Tissue processor
solution or chemical
28
 • Special stain/IHC
solution or chemical
 Equipment cleaning, maintenance
or troubleshooting.
 Chemical Waste Disposal
 Slide, block and sample filing

a
Table 4.6 Specimen Processing and Special Stain

ay
Work unit name Specimen Processing and Special Stain
Work area Histopathology Laboratory (Level 4)

al
Work unit staffing Male: - Females: 2
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function

M Specimen
Staining.
Processing and Special
of
Task involving chemical Routine:
 Sample management – receiving
ity

& registration
 Sample processing
rs

• Grossing
• Tissue processing
ve

• Tissue embedding
• Tissue sectioning and
ni

fishing
• Slide staining
U

• Slide mounting
• Slide sorting and
distribution
 Special stain and
Immunohistochemistry staining
Non-Routine:
 Frozen section session
29
  Chemical preparing
• Formalin
• Alcohol
• Acid alcohol
• Staining solution or
chemical
• Tissue processor
solution or chemical

a
• Special stain/IHC

ay
solution or chemical
 Equipment cleaning, maintenance
or troubleshooting.

al
 Chemical Waste Disposal

M
 Slide, block and sample filing
of
Table 4.7 Immunohistochemistry Staining
ity

Work unit name Immunohistochemistry Staining

Work area Immunohistochemistry Staining
rs

CLS/MLT (Level 4)
Work unit staffing Male: 1 Females: 1
ve

Work unit shift and time Normal: 8.30 AM to 5.30 PM

Work unit function To analyze tissue sample from hospital and
ni

other sources.
U

Task involving chemical Routine:

 Sample management – receiving
& registration
 Sample processing
• Grossing
• Tissue processing
• Tissue embedding
30
 • Tissue sectioning and
fishing
• Slide staining
• Slide mounting
• Slide sorting and
distribution
 Special stain and
Immunohistochemistry staining

a
Non-Routine:


ay
Frozen section session
 Chemical preparing
• Formalin

al
• Alcohol

M
• Acid alcohol
• Staining solution or
of
chemical
• Tissue processor
solution or chemical
ity

• Special stain/IHC
solution or chemical
rs

 Equipment cleaning, maintenance

ve

or troubleshooting.
 Chemical Waste Disposal

ni

Slide, block and sample filing

U

Table 4.8 Surepath Test

Work unit name Surepath Test

Work area Surepath Test CLS/MLT (Level4)
Work unit staffing Male: 1 Females: 4
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function To analyze the cervical samples.
31
 Task involving chemical Routine:
 Sample management – receiving
& registration
 Sample processing
• Slide labelling
• Fluid processing
• Slide clearing
• Slide staining

a
• Slide mounting
•

ay
Slide sorting and
distribution

al
Non-Routine:

M
 Cell block preparation
 Chemical preparing
of
• Alcohol rinse
• Tris buffer
• 90% alcohol
ity

• 70% alcohol
 Equipment cleaning, maintenance
rs

or troubleshooting.
ve

 Chemical Waste Disposal

ni

Table 4.9 Non Gynae Sample

U

Work unit name Non Gynae Sample

Work area Histopathology Laboratory (Level 4)
Work unit staffing Male: 1 Females: 3
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function To analyze the cervical samples and non-
gynae samples and produce result.
Task involving chemical Routine:
32
  Sample management – receiving
& registration
 Sample processing
• Slide labelling
• Fluid processing
• Slide clearing
• Slide staining
• Slide mounting

a
• Slide sorting and

ay
distribution

Non-Routine:

al
 Cell block preparation

M
 Chemical preparing
• Alcohol rinse
of
• Tris buffer
• 90% alcohol
• 70% alcohol
ity

 Equipment cleaning, maintenance

or troubleshooting.
rs

 Chemical Waste Disposal

ve
ni

Table 4.10 Cell Block Sample

Work unit name Cell Block Sample

U

Work area Histopathology Laboratory (Level 4)

Work unit staffing Male: 1 Females: 3
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function To prepare cell block and pass to
immunohistochemistry for further testing.
Task involving chemical  Received request from branch

33
  Spin the cytology fluid
 Add plasma and thromboplastin
 Vortex or tap gently on the
countertop
 Place the mass in formalin
 Cell block pass to
immunohistochemistry for further
testing.

a
Routine:

ay
 Sample management – receiving
& registration


al
Sample processing
• Slide labelling

M
• Fluid processing
• Slide clearing
of
• Slide staining
• Slide mounting
•
ity

Slide sorting and

distribution
rs

Non-Routine:
ve

 Cell block preparation

 Chemical preparing
ni

• Alcohol rinse
• Tris buffer
U

• 90% alcohol
• 70% alcohol
 Equipment cleaning, maintenance
or troubleshooting.
Chemical Waste Disposal

34
 Table 4.11 Bacteriology

Work unit name Bacteriology

Work area Bacteriology Laboratory Level 6
Work unit staffing Male: 1 Females: 5
Work unit shift and time Normal: 8.30 AM to 5.30 PM
Work unit function To receive samples, process, analyse the
microbiological samples and produce
result.

a
Task involving chemical Cleaning and disinfecting work bench,

ay
Sample collection,
Pre analytical - receiving

al
&registration,agar preparation &
macroscopic, sorting of plated specimens.

M
Analytical - Sample processing: Sample
streaking, staining & microscopic
of
examination.
Analytical – plate reading , staining &
ity

reporting
Analytical – bacteria identification &
rs

susceptibility testing
Post Analytical – finalizing identification
ve

and sensitivity & reporting

NON ROUTINE:
ni

Equipment cleaning, maintenance or

troubleshooting.
U

35
4.2 Hazard Rating

Hazard rating is concluded according to information about the physical properties of the

chemicals and its health hazards.

4.2.1 Work Unit: Biochemistry

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating

a
?

ay
1 Cell Wash Solution II / Acid Wash Irritant R36 SK 2
2 C.f.a.s. HbA1c Corrosive R34, R41 SK 3

al
3 C.f.a.s. Lipids Harmful R22 - 3

4 Eco
12x59ml
Tergent, Cobas
M
c501/502, Corrosive R22, R35 SK
R36, R48
4
of
5 NaOH (sodium hydroxide 2-5%) Irritant R36, R38 SK 2
6 ALB2 Irritant R36 SK 2
ity

7 ALP2 Irritant R36, R37 SK 3

8 ASLOT Harmful R21,R36 SK 3
rs

R60/61
9 BIL-D Gen. 2 Corrosive R34 SK 3
ve

10 BIL-T Gen. 3 Corrosive R35 SK 4

11 CHOL2 Toxic R22, SK 4
ni

R23/24/2
U

5, R34
R41,
R48/20/2
1/22
12 Creatine Kinase Harmful R22, SK 3
R34, R61
13 CREJ2 Corrosive R34 SK 3

36
 14 FRA Harmful R22 SK 3
R36/37/3
8, R41
15 IGA-2 Irritant R36 SK 2
16 IGG-2 Irritant R36 SK 2
17 IGM-2 Irritant R36 SK 2
18 IRON2 Corrosive R35 SK 4
19 MG2 Irritant R36, R38 SK 2

a
20 PHOS2 Corrosive R35 SK 4

ay
21 TP2 Corrosive R35 SK 4
22 TPUC3 Corrosive R20, R22 SK 4

al
R34, R35
23 UA2 Irritant R36 SK 2

M
24 UIBC Irritant R37, R40 SK 3
25 Sample Cleaner 2 Corrosive R35 SK 4
of
26 AMPS2 Harmful R22 - 3
27 C.f.a.s. PAC Harmful R22 - 3
ity

28 Steriline Harmful R21/22/3 SK 3

4
rs

29 CHOL2 Irritant R36 SK 2

ve

4.2.2 Haematology
ni

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
U

1 G6PDH Deficiency Screening Test Harmful R22, R32 - 3

2 SD Bioline Malaria Ag P.f/Pan, Irritant R36 SK 2
Assay diluent
3 Immersion oil Harmful R22 - 3

37
 4 Entellan Harmful R20, SK 3
R21, R38
5 Reticulocyte stain Harmful R21, SK 3
R22, R36
R37, R38
6 Leishman’s eosin methylene blue Toxic R23/24/2 SK 4
5
7 CELLCLEAN AUTO Corrosive R34 SK 3

a
8 Fluorocell WDF Harmful R22 - 3

ay
9 Fluorocell WNR Harmful R22 - 3
10 NOVACLONE Medical Diagnostic Harmful R22 - 3

al
Reagent
11 Histolene Irritant R36, SK 3

M
R37, R38
12 DEPEX Mounting Medium Toxic R24, SK 4
of
R60, R38
13 NaOH Irritant R36, R38 SK 2
ity
rs

4.2.3 Specimen Grossing

ve

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?
ni

1 Formalin 10% Harmful R20/21/2 SK 3

U

2, R40/43

38
4.2.4 Specimen Processing and Routine Staining

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?

1 Ultraclear Irritant R65, R37 - 3

2 Formalin solution 10% Harmful R20/21/2 SK 3
2, R40,
R43

a
3 Reagent Alcohol 100% Harmful R20/21/2 SK 3

ay
2
4 Decalcifier I®, Decalcifier I® Harmful R20/21/2 SK 3

al
Modified 2, R40,
R43
5
6
Decalcifier 2
Isopropanol 100% M Corrosive
Irritant
R34, R37
R36
SK
SK
3
2
of
7 Paralast™ Harmful R40 SK 3
8 Eosis 515Lt Harmful R36, SK 3
ity

R38,
R20/21/2
rs

2
9 Hematoxylin 560MX Harmful R22, R36 SK 3
ve

10 Sub-X® Xylene Substitute Harmful R40 - 3

11 Entellan® Harmful R20/21, SK 3
ni

R38
U

12 Eosin Y Irritant R36 SK 2

13 Ethanol 96 Irritant R36/37/3 SK 3
8
14 2-Propanol Irritant R36, R38 SK 2
15 Xylene (98.5%) Harmful R20/21, SK 3
R38
16 Hematoxylin 560 Harmful R22 - 3

39
4.2.5 Specimen Processing and Special Stain

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?

1 Acetic acid (>=10% - <20%) Irritant R36, R38 SK 2

2 Acetone (<=100%) Irritant R36, SK 2
R66, R67
3 Alcian Blue (>=1% - <5%) Corrosive R35 SK 4

a
ay
4 Ammonia solution 25% Corrosive R34, R37 SK 3
5 Methenamine (<100%) Sensitizing R43 SK 2

al
6 Sodium disulphite Harmful R31, SK 3
R22, R41
7
8
Sulphuric acid (>=25% - <50%)
Toluene (<100%)
M Corrosive
Harmful
R35
R63,
SK
SK
4
3
of
R48,
R20,
ity

R65, R38
9 Tungstophosporic acid hydrate Corrosive R34 SK 3
rs

(<=100%)
10 Hydrochloric acid (<36.5%) Corrosive R34 SK 3
ve

11 Chromium (VI) oxide (<=100%) Very Toxic R45, SK 5

R46,
ni

R62,
R26,
U

R24/25-
48/23,
R35,
R42/43

40
4.2.6 Immunohistochemistry Staining

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?

1 DAB Quanto Chromogen Irritant R36, SK 3

R37, R38
2 Quanto HRP Irritant R36, SK 3
R37, R38

a
3 Tri Buffered Saline Irritant R36 SK 2

ay
4 10X EZ Prep Solution, 2L Irritant R36, SK 3

al
R37, R38
5 10X SSC Solution, 2L Irritant R36, SK 3

6 Bluing Reagent
M Irritant
R37, R38
R36, R38 SK 2
of
7 Cell Ceonditioning Solution (CC2), Irritant R36 SK 2
1L
ity

8 Hematoxylin II Harmful R22, SK 3

R34,
rs

R36, R37
9 LCS Irritant R36, SK 3
ve

R37, R38
10 Ultra-view silver wash II Irritant R36, SK 3
ni

R37, R38
11 Ultra-view SISH DNP Detection Kit Harmful R43, R40 SK 3
U

12 Ultra-view Universal DAB Detection Irritant R38, SK 2

Kit R36, R45
13 Hydrogen peroxide 30% Harmful R22, R41 SK 3
14 INFORM HER2 DUAL ISH DNA Harmful R61, R40 - 3
PROBE CKTL US

41
 15 Reaction Buffer Concentrate Harmful R38, SK 3
R36, R20
16 Confirm ™ Primary Antibodies Irritant R36, SK 3
R37,
R38, R43
17 ULTRAVIEW RED ISH DIG Irritant R36 SK 2
DETECTION KIT

a
ay
4.2.7 Surepath Test

No Name of Chemical Hazard Risk Skin Hazard

al
Classification Phrases Notation Rating

M
?

1 Alcohol 100% Harmful R68, SK 3

of
R20,
R21, R22
2 BD Prepstain™ Alcohol Blend Rinse Harmful R36, R40 SK 3
ity

3 BD Prepstain™ Hematoxylin Stain Harmful R22, SK 3

R36,
rs

R37, R38
ve

4 Density Reagent Harmful R22 SK 3

5 DPX non-aqueous mounting medium Harmful R20, SK 3
ni

for microscopy R21, R38

6 Entellan® new rapid mounting Harmful R20, SK 3
U

medium for microscopy R21, R38

7 Histolene Irritant R38, R43 SK 2
8 Isopropanol 100% Irritant R36 SK 2
9 Sub-X® Xylene Substitute Irritant R36, SK 3
R37, R38
10 Hematoxylin 560 Harmful R22 - 3

42
 11 Orange G-6 Harmful R20, SK 3
R21,
R22, R68
12 Eosin 515 Lt Harmful R20, SK 3
R21,
R22, R68
13 Tris Buffered Saline Irritant R36, SK 3
R37, R38

a
ay
4.2.8 Non-Gynae Sample

al
No Name of Chemical Hazard Risk Skin Hazard

M
Classification Phrases Notation Rating
?
of
1 May-Grunwald Stain (Methanol Toxic R23/24/2 SK 4
100%) 5
ity
rs

4.2.9 Cell Block Sample

ve

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?
ni

1 STA® - NEOPLASTINE® CI PLUS Harmful R20, SK 3

U

R22,
R38, R43

43
4.2.10 Bacteriology

No Name of Chemical Hazard Risk Skin Hazard

Classification Phrases Notation Rating
?

1 TDA Reagent Irritant R36 2

SK
2 Peptidase Reagent Harmful R34, SK 3
R22,

a
R21,

ay
R20,
R37,

al
R38, R36
3 Indol Reagent Corrosive R37, R35 SK 4

4 Vitek-MS CHCA
MHarmful R20/21/2 SK 3
of
2,
R36/37/3
ity

8
5 Vitek-MS FA Corrosive R34 SK 3
rs

6 Xpert MTB/RIF Corrosive R34, SK 3

R36, R62
ve
ni
U

44
4.3 Exposure Rating

4.3.1 Biochemistry

No. Name of Chemical Frequency Degree Degree MR ER

Duration Chemical Contact
(FR) Release
1 Cell Wash Solution II / Acid 2 L L 1 2
Wash

a
2 C.f.a.s. HbA1c 2 L L 1 2

ay
3 C.f.a.s. Lipids 3 L L 1 2
4 Eco Tergent, Cobas c501/502, 3 L L 1 2

al
12x59ml
5 NaOH (sodium hydroxide 2-5%) 5 L L 1 3

M
6 ALB2 5 L L 1 3
7 ALP2 5 L L 1 3
of
8 ASLOT 5 L L 1 3
9 BIL-D Gen. 2 5 L L 1 3
ity

10 BIL-T Gen. 3 5 L L 1 3
11 CHOL2 5 L L 1 3
rs

12 Creatine Kinase 5 L L 1 3
13 CREJ2 5 L L 1 3
ve

14 FRA 4 L L 1 2
15 IGA-2 4 L L 1 2
ni

16 IGG-2 4 L L 1 2
17 IGM-2 4 L L 1 3
U

18 IRON2 5 L L 1 3
19 MG2 5 L L 1 3
20 PHOS2 5 L L 1 3
21 TP2 5 L L 1 3
22 TPUC3 5 L L 1 3
23 UA2 5 L L 1 3

45
 24 UIBC 5 L L 1 3
25 Sample Cleaner 2 5 L L 1 3
26 AMPS2 4 L L 1 2
27 C.f.a.s. PAC 2 L L 1 2
28 Steriline 2 L L 1 3
29 CHOL2 5 L L 1 3

a
4.3.2 Hematology

ay
No. Name of Chemical Frequency Degree Degree MR ER
Duration Chemical Contact

al
(FR) Release

M
1 G6PDH Deficiency Screening 2 L L 1 2
Test
of
2 SD Bioline Malaria Ag P.f/Pan, 3 L L 1 2
Assay diluent
3 Immersion oil 5 L L 1 3
ity

4 Entellan 5 L L 1 3
5 Reticulocyte stain 4 L L 1 2
rs

6 Leishman’s eosin methylene 5 L L 1 3

ve

blue
7 CELLCLEAN AUTO 5 L L 1 3
8 Fluorocell WDF 5 L L 1 3
ni

9 Fluorocell WNR 5 L L 1 3
U

10 NOVACLONE Medical 5 L L 1 3
Diagnostic Reagent
11 Histolene 5 L L 1 3
12 DEPEX Mounting Medium 5 L L 1 3
13 NaOH 4 L L 1 2

46
4.3.3 Specimen grossing

No. Name of Chemical Frequency Degree Degree MR ER

Duration Chemical Contact
(FR) Release

1 Formalin 10% 5 L L 1 3

a
ay
4.3.4 Specimen Processing and Routine Staining

No. Name of Chemical Frequency Degree Degree MR ER

al
Duration Chemical Contact
(FR) Release

M
1 Ultraclear 5 L L 1 3
2 Formalin solution 10% 5 M L 2 4
of
3 Reagent Alcohol 100% 5 M L 2 4
4 Decalcifier I®, Decalcifier I® 4 M L 2 4
ity

Modified
5 Decalcifier 2 4 M L 2 3
rs

6 Isopropanol 100% 5 M L 2 3
7 Paralast™ 5 M L 2 4
ve

8 Eosis 515Lt 5 M L 2 4
9 Hematoxylin 560MX 5 M L 2 4
ni

10 Sub-X® Xylene Substitute 5 M L 2 4

11 Entellan® 5 M L 2 4
U

12 Eosin Y 5 M L 2 4
13 Ethanol 96 5 M L 2 4
14 2-Propanol 5 M L 2 4
15 Xylene (98.5%) 3 M L 2 3
16 Hematoxylin 560 5 M L 2 3

47
4.3.5 Specimen Processing and Special Stain

No. Name of Chemical Frequency Degree Degree MR ER

Duration Chemical Contact
(FR) Release
1 Acetic acid (>=10% - <20%) 2 L L 1 2
2 Acetone (<=100%) 2 L L 1 2
3 Alcian Blue (>=1% - <5%) 3 L L 1 2
4 Ammonia solution 25% 3 L L 1 2

a
5 Methenamine (<100%) 4 L L 1 2

ay
6 Sodium disulphite 4 L L 1 3
7 Sulphuric acid (>=25% - <50%) 3 L L 1 3

al
8 Toluene (<100%) 4 L L 1 2
9 Tungstophosporic acid hydrate 3 L L 1 2

10
(<=100%)
Hydrochloric acid (<36.5%)
M3 L L 1 2
of
11 Chromium (VI) oxide (<=100%) 4 L L 1 2
ity

4.3.6 Immunohistochemistry
rs

No. Name of Chemical Frequency Degree Degree MR ER

Duration Chemical Contact
ve

(FR) Release
1 DAB Quanto Chromogen 5 L L 1 3
ni

2 Quanto HRP 2 L L 1 2
U

3 Tri Buffered Saline 1 L L 1 1

4 10X EZ Prep Solution, 2L 5 L L 1 3
5 10X SSC Solution, 2L 5 L L 1 3
6 Bluing Reagent 5 L L 1 3
7 Cell Ceonditioning Solution 5 L L 1 3
(CC2), 1L
8 Hematoxylin II 5 L L 1 3

48
 9 LCS 5 L L 1 3
10 Ultra-view silver wash II 5 L L 1 3
11 Ultra-view SISH DNP Detection 5 L L 1 3
Kit
12 Ultra-view Universal DAB 5 L L 1 3
Detection Kit
13 Hydrogen peroxide 30% 1 L L 1 1
14 INFORM HER2 DUAL ISH 4 L L 1 2

a
DNA PROBE CKTL US

ay
15 Reaction Buffer Concentrate 5 L L 1 3
16 Confirm ™ Primary Antibodies 5 L L 1 3

al
17 ULTRAVIEW RED ISH DIG 5 L L 1 3
DETECTION KIT

M
of
4.3.7 Surepath Test

No. Name of Chemical Frequency Degree Degree MR ER

ity

Duration Chemical Contact

(FR) Release
rs

1 Alcohol 100% 5 L L 1 2
2 BD Prepstain™ Alcohol Blend 5 L L 1 2
ve

Rinse
3 BD Prepstain™ Hematoxylin 5 L L 1 2
ni

Stain
4 Density Reagent 5 L L 1 2
U

5 DPX non-aqueous mounting 5 L L 1 2

medium for microscopy
6 Entellan® new rapid mounting 5 L L 1 2
medium for microscopy
7 Histolene 5 L L 1 2
8 Isopropanol 100% 5 L L 1 2
9 Sub-X® Xylene Substitute 5 L L 1 2
49
 10 Hematoxylin 560 5 L L 1 2
11 Orange G-6 5 L L 1 2
12 Eosin 515 Lt 5 L L 1 2
13 Tris Buffered Saline 5 L L 1 2

4.3.8 Non-Gynae Sample

a
No. Name of Chemical Frequency Degree Degree MR ER
Duration Chemical Contact

ay
(FR) Release
1 May-Grunwald Stain 5 L L 1 3

al
4.3.9 Cell Block Sample
M
of
No. Name of Chemical Frequency Degree Degree MR ER
Duration Chemical Contact
ity

(FR) Release
1 STA® - NEOPLASTINE® CI 5 L L 1 3
rs

PLUS
ve

4.3.10 Bacteriology
ni

No. Name of Chemical Frequency Degree Degree MR ER

U

Duration Chemical Contact

(FR) Release
1 TDA Reagent 5 L L 1 3
2 Peptidase Reagent 5 L L 1 3
3 Indol Reagent 5 L L 1 3
4 Vitek-MS CHCA 5 L L 1 3
5 Vitek-MS FA 5 L L 1 3

50
 6 Xpert MTB/RIF 5 L L 1 3

4.4 Adequacy of Existing Control

From the observation, the existing control measure mostly available and adequate. Personal

protective equipment were provided to staff such as nitrile glove, face mask, goggle and lab

coat. General ventilation and local exhaust ventilation were applied in laboratory area. Staff

a
used fume cupboard when handling the chemicals to perform their works and this equipment

ay
also have regular maintenance.

al
M
4.5 Conclusion of the Assessment
of
For the conclusion, risk rating is computed first based on hazard rating (HR) and exposure

rating (ER). Then, the conclusion can be made according to the risk rating (RR) and the
ity

assessment of existing control measures. The conclusion for every chemicals are shown in
rs

table below.
ve

4.5.1 Biochemistry

No Name of Chemical Risk Control Conclusion

ni

Rating Adequacy
(RR) (Yes/No)
U

1 Cell Wash Solution II / Acid Wash 2 YES C1

2 C.f.a.s. HbA1c 2 YES C1
3 C.f.a.s. Lipids 3 YES C2
4 Eco Tergent, Cobas c501/502, 12x59ml 3 YES C2
5 NaOH (sodium hydroxide 2-5%) 3 YES C2
6 ALB2 3 YES C2

51
 7 ALP2 3 YES C2
8 ASLOT 3 YES C2
9 BIL-D Gen. 2 3 YES C2
10 BIL-T Gen. 3 4 YES C2
11 CHOL2 4 YES C2
12 Creatine Kinase 3 YES C2
13 CREJ2 3 YES C2
14 FRA 3 YES C2

a
15 IGA-2 2 YES C1

ay
16 IGG-2 2 YES C1
17 IGM-2 2 YES C1

al
18 IRON2 4 YES C2
19 MG2 3 YES C2

M
20 PHOS2 4 YES C2
21 TP2 4 YES C2
of
22 TPUC3 4 YES C2
23 UA2 3 YES C2
ity

24 UIBC 3 YES C2
25 Sample Cleaner 2 4 YES C2
rs

26 AMPS2 3 YES C2
27 C.f.a.s. PAC 3 YES C2
ve

28 Steriline 3 YES C2
29 CHOL2 3 YES C2
ni
U

4.5.2 Haematology

No Name of Chemical Risk Control Conclusion

Rating Adequacy
(RR) (Yes/No)
1 G6PDH Deficiency Screening Test 3 YES C2

52
 2 SD Bioline Malaria Ag P.f/Pan, Assay 2 YES C1
diluent
3 Immersion oil 3 YES C2
4 Entellan 3 YES C2
5 Reticulocyte stain 3 YES C2
6 Leishman’s eosin methylene blue 4 YES C2
7 CELLCLEAN AUTO 3 YES C2
8 Fluorocell WDF 3 YES C2

a
9 Fluorocell WNR 3 YES C2

ay
10 NOVACLONE Medical Diagnostic 3 YES C2
Reagent

al
11 Histolene 3 YES C2
12 DEPEX Mounting Medium 4 YES C2

M
13 NaOH 2 YES C1
of
4.5.3 Specimen Grossing
ity

No Name of Chemical Risk Control Conclusion

Rating Adequacy
rs

(RR) (Yes/No)
1 Formalin 10% 3 No C3
ve
ni

4.5.4 Specimen Processing and Routine Staining

U

No Name of Chemical Risk Control Conclusion

Rating Adequacy
(RR) (Yes/No)
1 Ultraclear 3 YES C2
2 Formalin solution 10% 4 NO C3
3 Reagent Alcohol 100% 4 NO C3
4 Decalcifier I®, Decalcifier I® Modified 4 YES C2

53
 5 Decalcifier 2 3 YES C2
6 Isopropanol 100% 3 YES C2
7 Paralast™ 4 YES C2
8 Eosis 515Lt 4 YES C2
9 Hematoxylin 560MX 4 YES C2
10 Sub-X® Xylene Substitute 4 NO C3
11 Entellan® 4 NO C3
12 Eosin Y 3 YES C2

a
13 Ethanol 96 4 YES C2

ay
14 2-Propanol 3 YES C2
15 Xylene (98.5%) 3 NO C3

al
16 Hematoxylin 560 3 YES C2

M
4.5.5 Specimen Processing and Special Stain
of
No Name of Chemical Risk Control Conclusion
Rating Adequacy
ity

(RR) (Yes/No)
1 Acetic acid (>=10% - <20%) 2 YES C1
rs

2 Acetone (<=100%) 2 YES C1

3 Alcian Blue (>=1% - <5%) 3 YES C2
ve

4 Ammonia solution 25% 3 YES C2

5 Methenamine (<100%) 2 YES C1
ni

6 Sodium disulphite 3 YES C2

7 Sulphuric acid (>=25% - <50%) 4 NO C3
U

8 Toluene (<100%) 3 NO C3
9 Tungstophosporic acid hydrate 3 YES C2
(<=100%)
10 Hydrochloric acid (<36.5%) 3 YES C2
11 Chromium (VI) oxide (<=100%) 3 YES C2

54
4.5.6 Immunohistochemistry Staining

No Name of Chemical Risk Control Conclusion

Rating Adequacy
(RR) (Yes/No)
1 DAB Quanto Chromogen 3 NO C3
2 Quanto HRP 3 NO C3
3 Tri Buffered Saline 2 NO C1
4 10X EZ Prep Solution, 2L 3 NO C3

a
5 10X SSC Solution, 2L 3 NO C3

ay
6 Bluing Reagent 3 NO C3
7 Cell Ceonditioning Solution (CC2), 1L 3 NO C3

al
8 Hematoxylin II 3 NO C3
9 LCS 3 NO C3
10
11
Ultra-view silver wash II
Ultra-view SISH DNP Detection Kit
M 3
3
NO
NO
C3
C3
of
12 Ultra-view Universal DAB Detection 3 NO C3
Kit
ity

13 Hydrogen peroxide 30% 2 NO C1

14 INFORM HER2 DUAL ISH DNA 3 NO C3
rs

PROBE CKTL US
15 Reaction Buffer Concentrate 3 NO C3
ve

16 Confirm ™ Primary Antibodies 3 NO C3

17 ULTRAVIEW RED ISH DIG 3 NO C3
ni

DETECTION KIT
U

55
4.5.7 Surepath Test

No Name of Chemical Risk Control Conclusion

Rating Adequacy
(RR) (Yes/No)
1 Alcohol 100% 3 NO C3
2 BD Prepstain™ Alcohol Blend Rinse 3 NO C3
3 BD Prepstain™ Hematoxylin Stain 3 YES C2
4 Density Reagent 3 YES C2

a
5 DPX non-aqueous mounting medium 3 YES C2

ay
for microscopy
6 Entellan® new rapid mounting medium 3 NO C3

al
for microscopy
7 Histolene 2 YES C1
8
9
Isopropanol 100%
Sub-X® Xylene Substitute
M 2
3
YES
YES
C1
C2
of
10 Hematoxylin 560 3 YES C2
11 Orange G-6 3 YES C2
ity

12 Eosin 515 Lt 3 YES C2

13 Tris Buffered Saline 3 YES C2
rs
ve

4.5.8 Non-Gynae Sample

No Name of Chemical Risk Control Conclusion

ni

Rating Adequacy
U

(RR) (Yes/No)
1 May-Grunwald Stain 4 NO C3

56
4.5.9 Cell Block Sample

No Name of Chemical Risk Control Conclusion

Rating Adequacy
(RR) (Yes/No)
1 STA® - NEOPLASTINE® CI PLUS 3 YES C2

4.5.10 Bacteriology

a
No Name of Chemical Risk Control Conclusion

ay
Rating Adequacy
(RR) (Yes/No)

al
1 TDA Reagent 3 YES C2
2 Peptidase Reagent 3 YES C2
3
4
Indol Reagent
Vitek-MS CHCA M 4
3
YES
YES
C2
C2
of
5 Vitek-MS FA 3 YES C2
6 Xpert MTB/RIF 3 YES C2
ity
rs

4.5.11 Summary of the Assessment Conclusion

ve

Number of
Laboratory
Work Unit Chemicals Conclusion
Department
Assessed
ni

Biochemistry Biochemistry 29 C2
U

Haematology Heamatology 13 C2
Specimen Grossing Histopathology 1 C3
Specimen Processing and Routine 16
Histopathology C3
Staining
Specimen Processing and Special 11
Histopathology C3
Stain

57
Immunohistochemistry Staining Histopathology 17 C3
Surepath Test Cytopathology 13 C3
Non-Gynae Sample Cytopathology 1 C3
Cell Block Sample Cytopathology 1 C2
Bacteriology Microbiology 6 C2

a
ay
al
M
of
ity
rs
ve
ni
U

58
 CHAPTER 5

5.0 DISCUSSION

5.1 Conclusion of Assessment

From the result, all work units from Biochemistry, Haematology and Microbiology can be

concludes with C2. Therefore, these departments can continue with their current practice.

However, the work units from Histopathology and Cytopathology departments fall into C3

a
conclusion which is the risk of chemicals is significant but not adequately control. These

ay
departments need to identify precautions, measures, requirement for monitoring or health

surveillance that need to be taken to maintain controls and minimize exposures.

al
M
5.2 Technical Measures

5.2.1 Elimination / Substitution

of
From the observation, the chemicals used are essential in order to perform laboratory testing.
ity

Most of the laboratory analyser or equipment are provided together with their chemicals or

reagents. Therefore, there is no planning to eliminate or substitute those chemicals with high
rs

hazard rating. The staff can continue to use the chemicals with their existing control measure.
ve

5.2.2 Isolation / Enclosure

ni

All work unit is being carried out according to their specific area and isolated from other
U

activities. All laboratory department located at their respective floor such as Level 3, 4, 5 and

6 and separated from office area which located at Level 1 and 2. The flammable and corrosive

chemicals are stored separately within their designated cabinet storage. The chemicals are

stored separately because to prevent incompatible when stored together. Other than that,

chemical wastes disposal is located at separated area. The chemical waste is temporarily keep

in laboratory while waiting waste collection. Waste collection is held once a week and usually
59
on Friday. Prior to waste disposal, lab personnel will fill up waste collection form to indicate

the amount of waste generated at their laboratory.

5.2.3 Ventilation

The general ventilation and local exhaust ventilation are applied in all laboratory. General

ventilation refers to the ventilation system covering the entire work area. The general

a
ventilation system distributes fresh air through the work space through external air intake. Air

ay
from outside the workplace is mixed with the indoor air. The recommended ventilation rate

from various standards and guidelines varies from 4 to 12 air changes per hour (ACH) (Jin,

al
Memarzadeh, Lee, & Chen, 2012). There are about 10 to 12 ACH applied in the all laboratory

M
to control level of volatile chemicals and airborne contaminant concentration maintaining a

comfortable environment (Stuart, Sweet, & Batchelder, 2015). The general ventilation of the
of
workplace is suitable for the area does not produce other concentration of smoke, dust, or air
ity

pollutant. This is because the general ventilation system does not remove pollutants from the

air, but only dilutes them by mixing the air of working space with fresh supply from the outside.
rs

An efficient and capable method to this problem is the installation of local exhaust ventilation
ve

(LEV). LEV captures airborne contaminants close to the source of emission. It is generally

achieved by using hood, duct, air cleaner, fan and discharge which remove contaminants before
ni

they have a chance to escape in workstations. LEV is used in order to help reducing workers
U

exposure to contaminants at workstations. The use of LEV resulted in an overall exposure

reduction of 92% (Croteau, Flanagan, Camp, & Seixas, 2004). From the observation, there are

fume hood, biosafety cabinet, and article arm available in the laboratory. These equipment is

part of element for LEV system. Laboratory staff will using fume hood when handling the

chemicals to perform their task. The LEV system also were tested annually by Hygiene

Technician 2 registered with DOSH to ensure the system is effective. The effectiveness of the
60
LEV system is determined with sufficient air flow to capture the contaminants. Result of LEV

testing are found meet the minimum requirement of ACGIH Standard of Recommendation and

Australian Standard – Safety in Laboratories AS2243.8 Fume Cupboards.

5.2.4 Work Practice / System of Work

Laboratory staffs have shown their good work practice during performing their works. They

a
were briefed by lab manager and supervisor every time in the early morning before started

ay
their works. Lab manual and Standard Operating Procedure (SOP) are available and easily

accessible. Every work units have their own SOP for handling of chemicals hazardous to

al
health. Every incident or accident due to chemicals will be reported and investigated through

M
Incident Form.
of
Chemical register and safety data sheet are available in the laboratory. All chemicals must be
ity

registered in a form known as Chemical Hazardous List to Health based Guidelines for

Preparation of Chemical List. The chemical list and safety data sheet will provide information
rs

on trade and the general name, chemical composition, quantity used and location where
ve

chemicals are used or stored. Based on Method 5 (1), Occupational Safety and Health (Use

and Exposure Standards of Chemicals Hazardous to Health, 2000) specifies that employers
ni

should identify and record on the list of all hazardous chemicals to health used in the
U

workplace. This chemical list is used as a reference to staff regarding the dangers of chemicals

found in their workplace and the precautionary measures to take in case of accident (Husin et

al., 2012).

61
5.2.5 Personal Protection

Personal protective equipment (PPE) are compulsory to wear when entering the laboratory and

performing any work task. From the observation made, the staffs were equipped with necessary

PPE such as nitrile gloves, face mask, lab coat and safety glasses. Personal protective

equipment provided also located at an open and easy to access location. There are also PPE

issuance and PPE inspection form. This form need to be filled every months for records and

a
also to ensure the PPE available are in good condition. However, for work units under

ay
Histopathology and Cytopathology department, the adequacy and suitability of PPE need to be

assessed. These department involves with harmful chemical such as formalin, toluene and

al
xylene. The routes of entries are through inhalation, skin and eye contact. Thus, the chemical

M
exposure monitoring for these chemicals shall be carried out for the purposes of evaluating

current PPE provided.

of
ity

5.3 Action to Control

In order to control current condition, the chemical exposure monitoring for some chemicals
rs

need to be carried out. Chemical exposure monitoring is needed to ensure that airborne
ve

chemicals exposed to staffs are within permissible limits. These permissible exposure limits

(PELs) have been established by the Occupational Safety and Health Administration (OSHA).
ni

The purpose of this monitoring also to evaluate the suitability of personal protective equipment
U

such as nitrile gloves and face mask with the specific hazardous chemical such as

formaldehyde. If the results of the monitoring indicates the presence of health effects on the

staff, the current PPE needs to be substituted with other suitable PPE. According to the result

of this study, chemical exposure monitoring need to be carried out for formaldehyde, isopropyl

alcohol, xylene, ethanol and ethylene glycol.

62
In the Histopathology Laboratory, there is an unpleasant odor or smells of formaldehyde in the

atmosphere. Breathing of formaldehyde can cause irritation in the eyes and nose, which may

cause burning, stinging or itching sensations, a sore throat, watery eyes, blocked sinuses, runny

nose, and sneezing (Ahmed, 2011). Although, there are local exhaust ventilation are according

to ACGIH standard, it is recommended to improve general ventilation in order to reduce the

smells. There should be a minimum of 6 to 12 air changes per hour, and should be increased

a
until 12 ACH if the current ACH is insufficient. There should be also 100% exhaust to outside

ay
for all work area. This is to ensure air from the laboratory not be recirculated within a facility

(Karen, Anne, Rodney, Patrick, & Jonathan, 2007). Other than that, staffs need to use local

al
exhaust ventilation such as fume hood, article arm, grossing station and downdraft workstation

M
that available in the laboratory when handling the specimen.
of
It is recommended also for labelling of chemical’s container should follow the Occupational
ity

Safety and Health (Classification, Labelling and Safety Data Sheet for Hazardous chemical)

Regulations 2013. Ensure that all chemical’s container are clearly labeled with the chemical’s
rs

name, supplier information, signal word, hazards statements, hazard pictogram and
ve

precautionary statement (OSHA, 1994).

ni
U

63
 CHAPTER 6

6.0 CONCLUSION

This Chemical Health Risk Assessment was conducted at a private medical laboratory located

in Kuala Lumpur. The involved departments are Biochemistry, Hematology, Histopathology

and Cytopathology. This study was done according to the standards and guidelines set by the

a
Department of Occupational Safety and Health (DOSH). Through this assessment, chemicals

ay
hazardous to health were identified, and conclusion for each of the work unit had been assigned

respectively. Appropriate recommendation based on the safety data sheet, observation and

al
regulations were being made.

M
Overall, 10 work units with total 108 chemicals managed to be assessed. The assessments
of
conducted can be conclude that the risk of hazardous chemicals at the laboratories is significant
ity

either C2 or C3. Four work units were marked C2 and the other six work units fall under C3.

The work units that fall under C2 conclusion can continue the current practice and maintaining
rs

their control measure while for C3 conclusion, the current control measures can be further
ve

improved in the effort to provide safe working environment for laboratory staff. Although C2

can defined as the risk is significant and adequately controlled, the possibilities of risk might
ni

increase in the future if there is failure of control measures and change in the work process.
U

64
REFERENCES

Ahmed, H. O. (2011). Preliminary study: Formaldehyde exposure in laboratories of Sharjah

university in UAE. Indian Journal of Occupational & Environmental Medicine, 15(1),
33-37.

Becker, J. M., & Elston, H. J. (2004). You have what? An evaluation of three New Jersey
public school chemical inventories. Chemical Health and Safety, 11(5), 21-23.

a
doi:10.1016/j.chs.2004.04.002

ay
Bernstein, J. A. (2002). Material safety data sheets: Are they reliable in identifying human

al
hazards? Journal of Allergy and Clinical Immunology, 110(1), 35-38.
doi:10.1067/mai.2002.124891

M
Burton, D. (1997). General Methods for the Control of Airborne Hazards: Fairfax, VA: AIHA
of
Press.
ity

Bynam, L., Bordas, L., Hill, R. H., Katz, D., Langerman, N., Lechner, G., . . . Elston, H. J.
(2009). Deciding what to keep: The battle over chemical inventories in secondary
rs

school laboratories. Journal of Chemical Health and Safety, 16(6), 18-23.

doi:10.1016/j.jchas.2009.02.004
ve

CEOSH. (2013). Research Laboratory Safety Guidebook

ni

Volume 1: Managing Chemical Safety (Vol. Volume 1: Managing Chemical Safety). St. Louis,
Missouri: VHA Center for Engineering & Occupational Safety and Health (CEOSH).
U

Charney, W. (2010). Monitoring Aldehydes: Boca Raton: CRC Press.

Cournoyer, M. E., Maestas, M. M., Porterfield, D. R., & Spink, P. (2005). Chemical inventory
management: The key to controlling hazardous materials. Chemical Health and Safety,
12(5), 15-20. doi:10.1016/j.chs.2005.01.018

65
Croteau, G. A., Flanagan, M. E., Camp, J. E., & Seixas, N. S. (2004). The Efficacy of Local
Exhaust Ventilation for Controlling Dust Exposures During Concrete Surface
Grinding. Annals of Occupational Hygiene Journa, 48, 509 – 518.

DOSH. (2000). Assessment of the Health Arising from the Use of Hazardous Chemicals in the
Workplace.

Eguna, M. T., Suico, M. L. S., & Lim, P. J. Y. (2011). Learning to be safe: Chemical laboratory

a
management in a developing country. Journal of Chemical Health and Safety, 18(6),
5-7.

ay
Emery, R. (2013). A mechanism for providing institutional assurance for the safe handling of

al
acutely toxic or physically dangerous chemicals in research laboratories Journal of

M
Chemical Health and Safety, 20(1), 18-22.

Foster, B. L. (2003). Principles of laboratory safety management in academia. Journal of

of
Chemical Health and Safety, 10(2), 13-16.
ity

Foster, B. L. (2004). Laboratory safety program assessment in academia. Journal of Chemical

Health and Safety, 11(5), 6-13.
rs

Foster, B. L. (2007). In pursuit of excellence in safety. Journal of Chemical Health and Safety,
ve

14(3), 6-13.
ni

Gibbs, L. M. (2005). ChemTracker Consortium – The higher education collaboration for

U

chemical inventory management and regulatory reporting. Chemical Health and Safety,
12(5), 9-14. doi:10.1016/j.chs.2005.01.017

Greenberg, M., Cone, D. C., & Roberts, J. R. (1996). Material safety data sheet: A useful
resource for the emergency physician. Annals of Emergency Medicine, 27(3), 347-352.

HSW. (2015). Health, Safety & Wellbeing Handbook University of Adelaide.

66
Huntzinger, D. N., & Eatmon, T. D. (2009). A life cycle assessment of Portland cement
manufacturing: comparing the traditional process with alternative technologies.
Journal of Cleaner Production, 17(7), 668-675.

Husin, S. N. H., Mohamad, A. B., Abdullah, S. R. S., & Anuar, N. (2012). Chemical Health
Risk Assessment at The Chemical and Biochemical Engineering Laboratory. Procedia
- Social and Behavioral Sciences, 60, 300-307. doi:10.1016/j.sbspro.2012.09.383

a
Jin, M., Memarzadeh, F., Lee, K., & Chen, Q. (2012). Experimental study of ventilation
performance in laboratories with chemical spills. Building and Environment, 57, 327-

ay
335. doi:10.1016/j.buildenv.2012.04.022

al
Karen, K. M., Anne, C. B., Rodney, S. M., Patrick, J. M., & Jonathan, Y. R. (2007). Laboratory

M
Design; Approved Guideline (Second Edition ed.).

M. A. Jayjock, P. G. L., J. R. Lynch (2001). Quantitative level of protection offered to wokers

of
by ACGIH threshold limit values occupational exposure limits. American Industrial
Hygiene Association Journal, 62(1), 4.
ity

Mogopodi, D., Paphane, B., & Petros, S. (2015). Assessment of chemical management
rs

practices and safety in junior secondary school laboratories in Gaborone. Journal of

Chemical Health and Safety.
ve

OSHA. (1994). Occupational Safety and Health (Classification, Labelling and Safety Data
ni

Sheet of Hazardous Chemicals) Regulation 2013. Attorney General's Chambers.

U

OSHA. (2002). Hazardous Chemicals in Labs. OSHA Fact Sheet.

OSHA. (2003). An introduction to dangerous substances in the workplace (In E. A.f.S.a.H.a.

Work (Ed.) ed.): FACTS 33.

National Research Council Recommendations Concerning Chemical Hygiene in Laboratories

(Non-Mandatory), (2013).
67
Owens, B. (2014). Development of a policy to improve oversight of extremely hazardous
chemicals. Journal of Chemical Health and Safety, 21(3), 2-7.

Phillips, C. C., Wallace, B. C., Hamilton, C. B., Pursley, R. T., Petty, G. C., & Bayne, C. K.
(1999). The Efficacy of Material Safety Data Sheets and Worker Acceptability. Journal
of Safety Research, 30(2), 113-122.

a
Richards-Babb, M., Bishoff, J., Carver, J. S., Fisher, K., & Robertson-Honecker, J. (2010).
Keeping it safe: Chemical safety in the high school laboratory. Journal of Chemical

ay
Health and Safety, 17(1), 6-14.

al
Sarquis, M. (2003). Building student safety habits: Barriers and recommendations. Chemical

M
Health and Safety, 10(2), 10-12. doi:10.1016/s1074-9098(02)00453-7

Stuart, R., Sweet, E., & Batchelder, A. (2015). Assessing general ventilation effectiveness in
of
the laboratory. Journal of Chemical Health and Safety, 22(2), 2-7.
doi:10.1016/j.jchas.2014.10.001
ity
rs
ve
ni
U

68