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“Fear of Reporting” IANM V4 Story

This story is included in the fourth volume of Safety Partners’ publication, “Incidents, Accidents, and Near Misses in Laboratory Research.”

My good friend Monica was a lab tech in the early 2000’s.  She is now the Biosafety Officer at her current company and likes to share this story with new employees. It’s a wonderful anecdote—she took something scary and turned it into a teaching moment.

Working in Cambridge at her first “real job,” Monica was doing some tissue culture in the biosafety cabinet.  She worked with peripheral blood and amniotic fluid.  The company used open topped plastic biowaste containers, the size of a typical kitchen trash can, and double-lined them with red biowaste bags. The lab used a lot of serological pipettes, those long ones used for blood transfer, and the company didn’t treat them as sharps, so they would go in the red waste bag.

Biohazardous waste is expensive to dispose of. To save money and get the most room out of that container Monica would shake the open container, and smack it against the floor, over and over forcing waste settle at the bottom to make room for more discarded supplies. The people in the office area below her would tease her when she saw them in the elevator… ‘Oh, what on earth were you doing?  Having an elephant parade up there?” She would laugh because until that time, the only problem she caused was excess noise.

However, this one day, noise wasn’t the only problem. She was doing the “elephant parade” routine and there was liquid in the container and in a nano-second it splashed up and it went right underneath her safety glasses and into her eye.

It got right on the lower lid of her right eye. Terrified, she didn’t want to report her mistake. Her co-worker, Evan, knew how serious the situation was and was shaken up. “Oh my gosh, you need to go to Occupational Health or the emergency room or something.”

In Hot Water

Monica, who was and still is very conscientious, was very worried about getting in trouble due to her error. Finally, after seeing just how upset Evan was, Monica decided to inform her Safety Officer. Unfortunately, the Officer was too laid back and simply had her fill out a form instead of advising her to get medical attention. Luckily, Monica had her good friend Evan looking out for her.

Post-Exposure Evaluation

While the Safety Officer was blasé about the whole incident, Evan refused to take this matter lightly; after another two days of worrying about Monica he finally talked her into going to Occupational Health, regardless of whether she would get into trouble.  “This, after all, is your health,” he said. 

As is typical with exposure to potentially infectious biological material, Occupational Health wanted to discuss the potential for prophylactic treatment with Monica. The recommendation is that treatment begins within 2 hours of potential exposure, although such was not the case for Monica.

In these cases, proactive, immediate treatment outweighs delayed treatment every time.

When Monica tells this story now, she tells the truth – she thought long and hard about refusing the treatment out of fear of being penalized by her company. She knew intellectually that anytime someone got injured on the job or exposed to something, that person’s health is paramount. However, given the culture of this lab, she worried about showing any signs of weakness or error. If you spent too much time out of that lab you were seen as ineffective or irrelevant. She had lots of specimens to finish before the end of the day and wanted to keep on top of her work.

It’s been a long time since that incident, and Monica has been in Health and Safety for years now. Asked now how she would have dealt with her younger self, she replied, “We don’t treat employees like that. We need to look at the protocol or the procedure and change it so that it doesn’t happen again.” 

Safe, Not Sorry

Luckily, Monica followed up with a blood test six months later to see if she contracted anything – thankfully, she did not.

After a while, a policy was instituted in her lab that no longer allowed for compacting waste. The people on the floor below were happy with this change in the noise level!

Monica is thankful to have made it through this incident without any long term or serious effects and will always be grateful for the gentle nudge Evan gave her to go to Occupational Health. 

These days, as a Health and Safety professional, Monica champions a culture of safety.

Because Monica was potentially exposed to bloodborne illnesses as a result of this incident, OSHA’s bloodborne pathogen standard applied. The incident had to be recorded in compliance with OSHA regulations, which included the department or work area where the exposure incident occurred, an explanation of how the incident occurred, and recommendations on how to prevent the incident from reoccurring.  An entry on the OSHA log of work-related injuries and illnesses was recorded and maintained in a manner that protects the confidentiality of the injured worker (e.g., removal of personal identifiers).”

References:

HIV/AIDS Post-Exposure Prophylaxis. Centre for Disease Control. https://www.cdc.gov/hiv/basics/pep.html. Updated May 23 2018. Accessed Dec 29 2018.

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