Safety
Laboratory Safety Programs and Emergency Procedures
A clinical laboratory contains hazards that reach workers through sharps, splashes, aerosols, chemicals, energized equipment, pressure, cold, heat, radiation, and repetitive work. A safety program begins by identifying those routes, selecting controls, training the people who perform the work, and preparing the first response before an exposure occurs.
Safety program responsibilities
The employer evaluates hazards and places controls in the work process. Engineering controls such as safety needles, sharps containers, sealed centrifuge cups, biological safety cabinets, chemical fume hoods, ventilation, and equipment interlocks act before personal protective equipment (PPE). Written procedures then define safe work practices, PPE, training, medical evaluation, incident reporting, and emergency action. Employees use the controls, follow the procedures, and report a hazard or exposure promptly.
Three Occupational Safety and Health Administration (OSHA) standards define much of this work in a clinical laboratory:
| Standard | Main laboratory duties |
|---|---|
| Bloodborne Pathogens, 29 CFR 1910.1030 | Maintain a written exposure control plan; use universal precautions, engineering and work-practice controls, and PPE; provide hepatitis B vaccination and postexposure evaluation; train affected staff; and maintain required exposure records.1 |
| Hazard Communication, 29 CFR 1910.1200 | Maintain a written hazard communication program, workplace labels, accessible safety data sheets (SDSs), and employee information and training.2 |
| Occupational Exposure to Hazardous Chemicals in Laboratories, 29 CFR 1910.1450 | Maintain a written chemical hygiene plan with procedures, exposure controls, properly functioning protective equipment, training, prior-approval criteria, and medical consultation; designate personnel responsible for the plan, including a chemical hygiene officer.3 |
The facility safety program also incorporates applicable state worker-safety requirements, fire codes, environmental and sewer rules, radiation licenses, transport rules, accreditation requirements, and manufacturer instructions.
Current Hazard Communication transition
OSHA revised the Hazard Communication Standard in 2024 to align primarily with Revision 7 of the Globally Harmonized System. OSHA extended the transition dates in January 2026. As of August 2026, the remaining deadlines are:2,4
| Material and responsible party | Compliance date |
|---|---|
| Employers updating workplace labels, hazard communication programs, and training for substances | November 20, 2026 |
| Manufacturers, importers, and distributors evaluating mixtures | November 19, 2027 |
| Employers updating workplace labels, hazard communication programs, and training for mixtures | May 19, 2028 |
Manufacturers, importers, and distributors evaluating substances reached their deadline on May 19, 2026. During the applicable transition period, the standard permits use of the earlier requirements, the revised requirements, or both.
Biological hazard controls
OSHA uses universal precautions for occupational contact with human blood and other potentially infectious material. CDC Standard Precautions form the broader patient-care framework for blood, body fluids, secretions, excretions other than sweat, mucous membranes, and nonintact skin. PPE is selected for the exposure expected during the task.1,5
The chain of infection has six links: an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host. Laboratory controls interrupt one or more of these links.
| Exposure route | Primary controls |
|---|---|
| Percutaneous injury | Safety-engineered devices, immediate sharps disposal, puncture-resistant containers kept near the work, and mechanical pickup of contaminated broken glass |
| Splash to eyes, nose, or mouth | Splash control, sealed containers, and a mask with goggles or a face shield selected for the task |
| Skin or clothing contact | Gloves and a fluid-resistant coat or gown selected for the anticipated contact; hand hygiene after glove removal |
| Aerosol inhalation | Closed tubes, capped specimen containers, sealed rotors or safety cups, a certified biological safety cabinet for aerosol-generating work, and respiratory protection when the risk assessment and respiratory-protection program require it |
| Contaminated surface or equipment | Prompt containment, an approved cleaning procedure, and an EPA-registered disinfectant used at its labeled concentration and contact time |
Alcohol-based hand rub is preferred for most patient-care hand hygiene when hands are visibly clean. Soap and water are used when hands are visibly soiled and provide the physical removal needed for Clostridioides difficile spores. Facility policy may also require soap and water during an outbreak or other work involving spore-forming organisms.6
Used contaminated sharps go directly into a closable, puncture-resistant, leak-resistant, labeled or color-coded container that remains upright, accessible, and below its fill limit. Recapping, bending, breaking, or removing a contaminated needle is prohibited except when a specific procedure requires it or the employer can demonstrate that no feasible alternative exists. An allowed recapping or removal step uses a mechanical device or a one-handed technique. For routine phlebotomy, activate the safety feature and discard the needle and attached holder together.1,7
CDC and NIH describe four biosafety levels in Biosafety in Microbiological and Biomedical Laboratories (BMBL). BMBL is advisory guidance built around procedure-specific risk assessment. Class I biological safety cabinets protect personnel and the environment. Class II cabinets also protect the work product through HEPA-filtered downflow. Class III cabinets provide gas-tight, maximum containment. Cabinet type, exhaust connection, chemical use, and radionuclide use are selected through the risk assessment and the cabinet’s certification and installation requirements. Sealed centrifuge rotors or safety cups are opened inside appropriate containment after work that can generate infectious aerosols. A suspected tube break or containment failure follows the facility procedure and instrument instructions, including the specified settling time before the centrifuge is opened.8
Detailed biological safety cabinet airflow and type limits, organism-specific containment, and microbiology shipping procedures are covered in Specimen Collection, Transport, and Primary Processing in Microbiology.
Personnel entering a patient isolation area follow the posted transmission-based precautions in addition to Standard Precautions. Contact, droplet, and airborne controls are selected for the known or suspected route. Airborne precautions use an airborne infection isolation room when available. Tuberculosis care uses fit-tested respiratory protection under the facility’s respiratory-protection program. Other pathogens and aerosol-generating procedures follow their current CDC and facility requirements.5
Blood and body-fluid exposure
OSHA requires the exposure control plan to describe reporting and confidential postexposure evaluation. The plan is reviewed at least annually and when new or changed tasks alter exposure. Employees with occupational exposure receive annual training. Hepatitis B vaccination is offered at no cost after required training and within 10 working days of initial assignment, subject to the standard’s immunity, prior-vaccination, and medical exceptions.1
After a needlestick, sharps injury, or contact of blood or other potentially infectious material with mucous membrane or nonintact skin:
- Wash needlesticks, cuts, and exposed skin immediately with soap and water. Flush an exposed eye, nose, or mouth immediately with water.
- Report the exposure through the facility’s urgent pathway. Record the device, route, body site, fluid, circumstances, and source information.
- Obtain confidential medical evaluation promptly. The clinician evaluates the source and exposed worker, orders baseline testing, and selects prophylaxis and follow-up under current guidance and applicable consent law.
| Virus | Main follow-up decision |
|---|---|
| HIV | Start postexposure prophylaxis as soon as possible when indicated, up to 72 hours after exposure, and continue the prescribed 28-day course. Current U.S. Public Health Service guidance uses final laboratory HIV antigen/antibody and diagnostic nucleic acid testing at week 12. An interim 4- to 6-week test is added for specified circumstances, including delayed initiation or missed doses.9 |
| Hepatitis B virus | Base prophylaxis on the source patient’s HBsAg result and the worker’s vaccination history and documented anti-HBs response. The indicated action may include hepatitis B vaccine, hepatitis B immune globulin, both, or no additional prophylaxis.10 |
| Hepatitis C virus | Obtain baseline anti-HCV with reflex HCV RNA as soon as possible, preferably within 48 hours. When follow-up is indicated, test HCV RNA at 3 to 6 weeks and anti-HCV at 4 to 6 months, with reflex RNA after a reactive antibody result.11 |
The sharps injury log protects the injured employee’s identity and records the device type and brand, the department or work area, and an explanation of how the incident occurred. The log supports selection and review of safer devices.1
Specimen transport and waste
Within a facility, blood and other potentially infectious material travels in a closed container that prevents leakage. If the outside of the primary container is contaminated, it is placed in a second container that prevents leakage and is labeled or color-coded. Required biohazard labels or color coding also apply when specimens leave the facility, subject to the specific exceptions in the Bloodborne Pathogens Standard.1
Transportation in commerce follows U.S. Department of Transportation rules. Classification comes before packaging because the assigned class determines the package, marks, documentation, quantity limits, training, and carrier requirements.12,13
| Classification | Meaning and general package |
|---|---|
| Category A infectious substance | Material in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals after exposure. Use the specification packaging and documentation required by 49 CFR 173.196 and the transport mode. |
| Biological substance, Category B, UN3373 | Infectious material outside Category A. Use a leakproof primary receptacle, leakproof secondary packaging, absorbent sufficient for liquid contents, and a rigid outer package that meets 49 CFR 173.199. |
| Excepted patient sample | A patient sample meeting a specific 49 CFR 173.134 exception, including the applicable low-probability or exclusive-vehicle conditions. Package it under the conditions of that exception. |
Air shipment also follows the carrier and applicable international air-transport requirements. A trained shipper makes the final classification and prepares the package.
OSHA defines regulated waste by its blood or other potentially infectious material content and requires appropriate containment. State and local programs govern most medical-waste categories, treatment, and disposal, while DOT governs covered transport. Sharps stay in their approved containers. Other regulated waste goes into a closable, leak-resistant, labeled or color-coded container that is closed before removal.1,14
Chemical waste goes into the assigned, compatible, labeled waste stream. Sewer discharge or bench neutralization requires specific authorization in the facility’s environmental health and safety procedure and compliance with the local pretreatment rules. The authorized waste-stream review determines sewer eligibility. Sodium azide requires special control because it can react with copper or lead plumbing and form explosive metal azides.15,16
Chemical safety
Incoming hazardous-chemical labels remain legible and attached. SDSs remain readily accessible to employees during each work shift. OSHA requires the 16-section SDS format and leaves enforcement of sections 12 through 15 to the agencies that regulate those subjects.2
| SDS sections | Information |
|---|---|
| 1–4 | Identification; hazard identification; composition and ingredients; first-aid measures |
| 5–8 | Firefighting; accidental release; handling and storage; exposure controls and PPE |
| 9–11 | Physical and chemical properties; stability and reactivity; toxicological information |
| 12–15 | Ecological, disposal, transport, and regulatory information |
| 16 | Other information, including preparation or revision date |
Under OSHA, a flammable liquid has a flash point at or below 93°C (199.4°F); its category also depends on flash point and boiling point.17 Store chemicals by compatibility and the SDS. The facility’s approved compatibility plan separates flammables, oxidizers, reducing agents, acids, bases, water-reactive chemicals, and other incompatible materials as their hazards require. Secondary containment limits spread after a leak. Peroxide-forming chemicals are dated on receipt and opening, protected from heat and light, and tested or removed on the schedule assigned to the specific chemical. Sealed flammable liquids that require refrigeration go into a laboratory-grade, flammable-rated refrigerator or freezer.17
A chemical fume hood controls hazardous vapors. It is used at its marked sash height and kept within the facility’s certified operating range. Paper, equipment, and stored bottles can disrupt airflow. A tissue or smoke check shows airflow direction; quantitative measurement and certification establish hood performance.3
Spill and splash response
The substance, quantity, exposure route, and ability of trained staff determine the response.
| Event | First response |
|---|---|
| Small chemical spill within the worker’s training and spill-kit capability | Alert nearby staff, restrict the area, consult the SDS and chemical hygiene plan, wear the specified PPE, use the assigned spill material, and place cleanup waste in its designated stream.3,17 |
| Chemical spill with toxic vapor, fire, violent reaction, unknown identity, large volume, or exposure beyond local capability | Activate the emergency plan, evacuate or isolate the area as directed, and call the designated emergency responders.3,17 |
| Biological spill | Alert nearby staff, restrict the area, allow aerosol settling when the biosafety procedure requires it, wear the specified PPE, contain and absorb liquid, collect broken glass with tongs or forceps, and apply an EPA-registered disinfectant at its labeled concentration and wet contact time.8,18 |
| Chemical splash to eyes or body | Start drenching or flushing immediately. Irrigate an exposed eye continuously for at least 15 minutes, removing contact lenses during flushing, and continue longer when the SDS directs. For skin or body exposure, use the safety shower, remove contaminated clothing when appropriate, and follow the substance-specific SDS and occupational-health pathway. OSHA requires suitable quick-drenching or flushing facilities within the work area where corrosive exposure can occur.19 |
Fire, equipment, and physical hazards
Fire requires fuel, heat, oxygen, and a sustained chemical chain reaction. The available extinguisher must match the expected fire class. Employees use a portable extinguisher only when the emergency plan assigns that duty, training is current, the fire is in its incipient stage, and a safe exit remains available. OSHA requires monthly visual inspection and annual maintenance of portable extinguishers. Employees expected to use them receive initial and annual education or training.20,21
| Fire class | Fuel | Extinguisher selection |
|---|---|---|
| A | Paper, wood, cloth, and other ordinary combustibles | Water, foam, or multipurpose dry chemical as approved for the unit |
| B | Flammable liquids and gases | Carbon dioxide or approved dry chemical or foam |
| C | Energized electrical equipment | A nonconductive agent approved for Class C use; deenergization changes the remaining fuel to its underlying class |
| D | Combustible metals | The specialized dry agent selected for the specific metal |
Many facilities teach RACE for the initial fire response: rescue a person in immediate danger, activate the alarm, confine the fire by closing doors, and extinguish or evacuate according to the plan. PASS describes operation of a common portable extinguisher: pull the pin, aim at the base, squeeze the handle, and sweep across the fire. Posted instructions and facility training control the actual response.
| Hazard | Main controls |
|---|---|
| Electrical | Inspect cords and plugs, keep hands and work surfaces dry, use grounded equipment and required ground-fault protection, preserve covers and interlocks, and deenergize equipment before authorized service. During a shock event, never touch the person while the circuit is energized. Disconnect power and call emergency responders. If power cannot be disconnected safely, keep others away; only a trained responder acting under the facility plan may use a suitable nonconductive rescue device.21 |
| Compressed gas | Store cylinders upright and secured; use the correct regulator and fittings; keep the valve cap on during cart transport; and separate incompatible gases and materials under the facility and fire-code plan.21 |
| Cryogenic liquid | Use a vented vessel designed for the temperature, control oxygen-displacement risk, and wear eye or face protection, a coat or apron, and loose-fitting cryogenic gloves that can be removed quickly. Use tools to retrieve material from liquid nitrogen.22 |
| Centrifuge and moving equipment | Balance loads, inspect rotors and cups, keep lids and interlocks functional, wait for complete stop, and use sealed containment when the material can create an infectious aerosol.8,22 |
| Ionizing radiation | Apply license conditions, training, access control, signage, surveys, monitoring, and time-distance-shielding controls through the radiation safety program. Radioactive waste follows the facility’s radioactive-material license and radiation safety officer instructions. NRC licensees retain individual monitoring records until termination of the pertinent license.23 |
| Non-ionizing radiation | Control ultraviolet, laser, radiofrequency, microwave, and infrared sources through source-specific enclosure, interlocks, shielding, warning signs, and eye or skin protection.21 |
| Ergonomic load | Adjust bench, chair, reach, and viewing height; use low-force or electronic pipettes when suitable; vary repetitive tasks; keep wrists and shoulders near neutral; and use carts, lifting devices, or help for heavy or awkward loads.24 |
Pain, numbness, tingling, weakness, or loss of grip can signal a work-related musculoskeletal disorder. Early reporting allows the task and workstation to be assessed before injury progresses.
Emergency action and incident records
An emergency action plan defines how to report a fire or other emergency, how alarms communicate the required action, which route to use, how staff are accounted for after evacuation, who may remain for critical operations, who performs rescue or medical duties, and who answers questions about the plan. The employer reviews the plan with each covered employee at initial assignment and whenever duties or the plan change. Alarms must be perceptible to every worker who needs to act.25
Before work begins, personnel locate the nearest exit, alarm, eyewash, safety shower, spill kit, sharps container, fire extinguisher, and emergency contact instructions. The laboratory schedules and documents periodic fire, evacuation, and spill drills to test whether the local plan works under the conditions and staffing of each shift.17,25
Every injury, exposure, spill, equipment failure, and near miss follows the facility reporting procedure. The record preserves the immediate response, people and materials involved, exposure route, equipment or device, affected work, medical referral, and corrective action. Investigation examines work design, environment, equipment, training, and supervision. The broader corrective-action method is covered in Quality Control, Method Evaluation, and Quality Management.
OSHA requires an employer to report a work-related fatality within 8 hours and a formal inpatient hospitalization, amputation, or loss of an eye within 24 hours. Required OSHA injury and illness records are retained for 5 years after the end of the calendar year they cover. Employee exposure records are generally retained for at least 30 years, and employee medical records are generally retained for the duration of employment plus 30 years, subject to the exceptions in the applicable standards.26,27
References
- Occupational Safety and Health Administration. 29 CFR 1910.1030: Bloodborne pathogens. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.1200: Hazard Communication. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.1450: Occupational exposure to hazardous chemicals in laboratories. Accessed August 29, 2026.
- Occupational Safety and Health Administration. Hazard Communication Standard 2024 final rule: extension of compliance dates. Published January 15, 2026. Accessed August 29, 2026.
- Centers for Disease Control and Prevention. Precautions to prevent transmission of infectious agents; recommendations for application of Standard Precautions for the care of all patients in all healthcare settings. Accessed August 29, 2026.
- Centers for Disease Control and Prevention. Clinical safety: hand hygiene for healthcare workers. Accessed August 29, 2026.
- Occupational Safety and Health Administration. Re-use of blood tube holders. June 12, 2002. Accessed August 29, 2026.
- Centers for Disease Control and Prevention, National Institutes of Health. Biosafety in Microbiological and Biomedical Laboratories. 6th ed. US Department of Health and Human Services; 2020. Accessed August 29, 2026.
- Kofman AD, Struble KA, Heneine W, et al. 2025 US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for post-exposure prophylaxis in healthcare settings. Infect Control Hosp Epidemiol. 2025;46(9):863-873. doi:10.1017/ice.2025.10254.
- Centers for Disease Control and Prevention. Table 1: Treatment for HBV exposures in health care settings. Updated May 13, 2024. Accessed August 29, 2026.
- Moorman AC, de Perio MA, Goldschmidt R, et al. Testing and clinical management of health care personnel potentially exposed to hepatitis C virus: CDC guidance, United States, 2020. MMWR Recomm Rep. 2020;69(RR-6):1-8. doi:10.15585/mmwr.rr6906a1.
- Transportation of hazardous materials: infectious substances. 49 CFR §173.134, §173.196, §173.199 (2026). Accessed August 29, 2026.
- Pipeline and Hazardous Materials Safety Administration. Transporting infectious substances overview. Accessed August 29, 2026.
- US Environmental Protection Agency. Medical waste. Updated April 20, 2026. Accessed August 29, 2026.
- US Environmental Protection Agency. Pretreatment standards and requirements: general and specific prohibitions. Accessed August 29, 2026.
- Centers for Disease Control and Prevention. Sodium azide. Updated June 11, 2026. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.106: Flammable liquids; Appendix A to 29 CFR 1910.1450: National Research Council recommendations concerning chemical hygiene in laboratories. Accessed August 29, 2026.
- US Environmental Protection Agency. Selected EPA-registered disinfectants. Accessed August 29, 2026.
- Occupational Safety and Health Administration. Requirement to provide accessible quick drenching and flushing facilities where there is exposure to corrosive materials. February 27, 2007. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.157: Portable fire extinguishers. Accessed August 29, 2026.
- Occupational Safety and Health Administration. Laboratory Safety Guidance. OSHA 3404-11R; 2011. Accessed August 29, 2026.
- Centers for Disease Control and Prevention. Guidelines for safe work practices in human and animal medical diagnostic laboratories. MMWR Suppl. 2012;61(1):1-102. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.1096: Ionizing radiation. Accessed August 29, 2026. Standards for protection against radiation: records of individual monitoring results. 10 CFR §20.2106 (2026). Accessed August 29, 2026.
- National Institute for Occupational Safety and Health. About ergonomics and work-related musculoskeletal disorders. Updated February 21, 2024. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.38: Emergency action plans; 29 CFR 1910.165: Employee alarm systems. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1904.39: Reporting fatalities, inpatient hospitalizations, amputations, and losses of an eye; 29 CFR 1904.33: Retention and updating. Accessed August 29, 2026.
- Occupational Safety and Health Administration. 29 CFR 1910.1020: Access to employee exposure and medical records. Accessed August 29, 2026.