Introduction
Health and safety are part of our professional lives. Forensic scientists are exposed to numerous and varied health risks on a daily basis, from the controlled setting of a laboratory, to the unpredictable nature of a crime scene. Health and safety measures are adopted to reduce the chance of an accident, but at some level it is the responsibility of each of us to check our working habits every day and address safety concerns as they appear. A good understanding of how accidents occur, and how they are avoided, not only reduces the chance of an accident in the workplace but can affect safety in other areas of our lives. A safe kitchen or garage is as important as a safe laboratory. The safety of our family and friends is as important as that of our colleagues.
Good health and safety comes from the top. If management does not actively support a health and safety program, it is unlikely that employees will follow suit. A commitment to safety involves not only written policies but also the allocation of money for equipment, time for designated safety personnel to do their tasks, meetings to discuss safety issues, and development of a clear expectation of disciplinary action for continued safety violations. However, there are many reasons for management to take an active role in supporting a safety program. Good health and safety means less time off work from accidents, reduced liability risk, better quality control and reduced risk of the contamination of evidence.
It is not possible to review all of the health and safety issues in this short article. The aim is to give the reader an overview from which to work, and encourage further learning from available texts, courses and conferences.
What is an Accident?
An accident is an unplanned event that causes some kind of harm. In many cases, the harm is obvious, such as an acid burn to the arm, or exposure to a disease. In other cases, the harm may be more obscure, such as financial loss, the destruction of property from fire, or a mental scar.
Hazards
All accidents are caused by a hazard. A hazard is anything that can cause harm. In a forensic laboratory setting, hazards include chemical, physical, biological and electrical sources. At a crime scene, there may be other hazards in addition to the above, such as falling through a hole in a floor, or attack by a family pet. When identifying hazards it will seem that most things can cause harm under certain circumstances. Water in a container poses little threat, but spilled on a tiled floor is a slip hazard. The hazards in our work environment need to be addressed to assess their severity and the likelihood that they will cause harm. The chance of a hazard causing harm is called ‘risk’.
How Accidents Occur
It is common to think of an accident as a single event. If a person trips over a power extension cord lying on the floor and falls, breaking an arm, we often address that accident as a one-off event and blame whoever put the power cord on the floor that day. However, accidents are typically not single events. It is usually the combination of several factors that leads up to the accident. In the case of the power cord, consider some of the other factors:
• How long has the power cord been on the floor?
• How many people tripped on the power cord and said nothing?
• Why was a power cord in use? Why was there no power in the area being worked?
• Who put the power cord there and why did they do it? Were they trained in the safe use of power cords?
• Who was supervising this area and allowed the power cord to stay?
• Were signs or mats available to warn of a trip hazard or to cover the cord entirely?
• How good was the lighting in that area?
The accident has been analyzed in terms of its ‘direct cause’ and ‘indirect causes’. The direct cause of the broken arm was the person tripping on the cord and falling. The indirect causes are listed above. There is a domino effect of indirect causes leading to the direct cause. If one domino (indirect cause) is removed, then the direct cause (the accident) may not occur. The identification and rectification of indirect causes is key to accident prevention.
Risk Assessment
An effective risk management program is dependent upon the ability of laboratory personnel to identify and prioritize the presence of risks, and to identify potential hazards before a work-related accident occurs. This will assist in the establishment of effective work practices, engineering controls and administrative controls, which all contribute to a safe working environment. The forensic laboratory and the crime scene have a myriad of potential risks, due in part to the laboratory environment and in part to the nature of evidence examination. In order to perform risk assessment, two factors should be considered:
1. Predict the possibility of an accident occurring.
2. Determine the extent of the consequences should an accident occur.
Near Misses
A near-miss accident or incident occurs when an employee nearly has an accident but is able to avoid it. Assessment of near-miss incidents will also assist in identifying job hazards before a work-related accident occurs. Communication of common safety experiences may lead to the development of fresh alternatives to unsafe habits. Safety managers must initiate a reporting process for near-miss incidents. Each near miss, injury or accident should be investigated to determine the specific cause and whether any actions are needed to prevent recurrence. Develop and test the solutions, implementing the most effective. Ultimately, evaluate the results. Regular review of safety records will aid in the identification of injury patterns or new areas of concern.
Response to Incidents
The proper response to a dangerous situation lies at the heart of many of the elements that make up the safety and health program. You want the staff instinctively to make safe choices, to maximize the impact of the response and minimize threat and damage. Delivery on this goal relies on: (1) the realism and frequency of training; (2) promptness and completeness of response to incidents and near misses; and (3) documentation and use of historical information related to the program.
There is a symbiotic relationship involved with these three elements of the health and safety program. As you determine the training needs during start-up of the program, it is important to consider incidents that have happened in the past. You may have to rely on anecdotes in the absence of firm documentation. As you listen to the stories, search for the root causes and determine which portions of the safety manual might address the underlying unsafe practice, equipment or procedure.
You are likely to find common issues at the root of previous safety incidents and near misses. Tailor your training priorities so that – in addition to required annual focus on fire response, bloodborne pathogens and chemical hygiene – you train the staff on the appropriate response and practices needed to avoid recurrence of historically prevalent problems. When a problem or near miss occurs, insure that you document it promptly and fully, and compile a running list of these incidents each quarter. Post the incidents so that staff can be informed of issues, and schedule training around the recurring problems. Alter the safety program to better prepare for and preclude recurrence of these problems, and alert supervisors to be particularly vigilant for root causes of these common issues during monthly audits.
It is a management truism (graphically depicted in the well-known Paretto chart) that 80% of significant issues of quality or safety can be traced to a single type of causative stimulus. If you identify and focus effort on eliminating this root stimulus, 80% of the remaining problems may be traced to another single causative stimulus. In any human system, you can never remove all the problems, but by systematically eliminating root safety concerns, the overall number of safety concerns and unsafe acts is quickly reduced. Systematic approaches and vigilance work together to provide a reasonable chance for success in the health and safety program.
The Facility
The setup of a laboratory is established when the facility is first occupied for use. Changes in technology and work tasks throughout the years may make the layout inadequate for current applications. Often we adapt to a laboratory setting that is no longer appropriate to contemporary usage. Assessment can include the design of workstations, scientific products, optical systems and displays to enhance the health and safety of employees. For example, consider relocating frequently used items to a more convenient and accessible area, thus reducing laborious reaching and bending. Examine laboratory office and bench chairs. Do these chairs provide the analyst with ergonomic comfort consistent with the job function? Improving comfort for the examiner who performs microscopic analysis can reduce eye, back and forearm strain. The forensic analyst often spends long hours at the laboratory bench. Appropriate height of the workbench surface will promote neutral postures, thus reducing development of chronic strain and injury.
Storage
Safe and secure evidence storage space that does not pose a health hazard from contaminated clothing, etc. is a taxing problem for many forensic laboratories. Often, large volumes of evidence must be stored prior to examination. Assessment of the evidence storage area should include consideration of appropriate storage height. Heavy items should be stored at heights that do not require overhead reaching or increased bending. Ladders or stools should be available to retrieve evidence stored above chest height. Employees should be trained in proper lifting techniques to reduce the possibility of back strain and injury.
Specific attention must be paid to the proper storage and handling of compressed gases. Gas cylinders are ‘rockets in waiting’, and must be secured and appropriately labeled at all times.
Obstructions
Attention to proper housekeeping and maintenance may reduce the risk of trips and falls that occur as a result of aisle clutter. In general, an obstructed aisle will not lead to a severe accident. Employees may suffer a strain or bruise as a result of tripping over an obstruction. However, the consequences rise dramatically if, in the event of an emergency, an obstructed aisle prevents or delays an employee from leaving the facility.
Electrical
Many forensic laboratories have a large inventory of computer-driven instrumentation, including spectro-photometers, gas chromatographs with various detectors, scanning electron microscopes and DNA sequencers. In addition to the risk of shock, short circuits can produce electrical arcs, leading to injury or fire. Proactive intervention begins with mechanical measures. Safe installation of electrical equipment by qualified personnel, combined with insulation proper to the voltage, will reduce shock hazards. Risk assessment should include proper maintenance of equipment in order to reduce the risk of deterioration creating an unsafe condition. Equipment should be located in a space sufficient to allow the heat produced to ventilate properly. Electrical cords must be appropriately secured, reducing the chance of trips or accidental disconnection. Personnel should be trained to inspect cords for signs of wear routinely and replace as needed.
Body Fluids
The forensic scientist routinely examines clothing and evidence contaminated with body fluids. The risk of exposure is a frequently occurring event with severe consequences. Personal protective equipment reduces the potential for an exposure to these fluids. Management must provide employees with personal protective equipment that is comfortable and appropriate to the task. Comfort will contribute to improved compliance. Protective measures against infectious agents should be directed against the routes of transmission and exposure. Gloves provide a protective barrier while handling evidence. Mucous membranes should be protected with a facemask in combination with goggles or full-face shield whenever working with liquid body fluids or their extracts. These measures must also be reinforced by a general attention to laboratory cleanliness and hygiene. Employees must regularly inspect and decontaminate reusable receptacles, such as buckets, centrifuges, cans and carts, that may be contaminated with infectious materials. Cleaning and decontamination of equipment work surfaces and utensils are an effective means of minimizing accidental transmission of diseases.
Sharps
Reducing the risk of puncture or cuts involves proper training in combination with adequate protective equipment. The forensic chemist may perform an examination of used hypodermic syringes for the presence of controlled substances. Cocaine and heroin intravenous users are high-risk populations for hepatitis, HIV infection and other infectious diseases. Proper training involves containing the syringe and needle in a leak-proof, puncture-resistant container before submission for analysis. Gloves should be donned prior to handling the syringe. Skin punctures usually occur as a result of recapping the needle; this, therefore, should not be practiced. After examination the syringe should be returned, uncapped, to the container. The container is then sealed and returned to evidence. Accidents involving broken glass should be handled with mechanical means, such as forceps or a dustpan and brush, thus reducing the possibility of cuts. If the broken glass object contained, or was contaminated with, blood or other potentially infectious material, remember to disinfect the clean-up utensils after use.
Chemicals
In addition to body fluids, the forensic scientist will routinely handle chemicals in various analyses. Eye protection in the form of goggles or full-face shield should be considered when the possibility of liquid splashes or spills exists. Assessment of risks should include response to spills. A convenient location for maintenance of the Material Safety Data Sheet (MSDS) library should be established. Access to MSDS, safety manuals and other safety documentation may be assured through computers located throughout the laboratory. Each laboratory employee should be well informed as to the location and how to interpret the information of an MSDS.
Spill kits should be readily available to employees who have been trained in proper clean-up. Spill response should include immediate notification to personnel that a spill has occurred, donning protective equipment prior to containment, clean-up and proper disposal. Chemical spill training will reduce the possibility of hazardous chemical exposure to employees.
Hoods
Routine inspection of chemical and biological hoods will protect employees from exposure to hazardous vapors and infectious materials. Hoods containing a filter system should have scheduled filter replacement appropriate to the manufacturer’s recommendation. Face velocity flow tests should be conducted routinely to assure proper hood operation.
Scene Work
Hazards in the laboratory occur in a controlled setting. In many ways, it is the often unpredictable nature of the scene that poses unforeseen hazards and far higher risks for the forensic scientist. There are four basic scene scenarios: crime scene, autopsy, fire scene and clandestine laboratory.
Crime scene
Response to crime scenes requires forensic personnel to be adequately trained in health and safety issues. Each member of the response team must make observations and respond appropriately. The crime scene can be in places as different as the bilge area of a ship or the side of a highway. Physical hazards must be assessed before any work is done. The scientist must ask: ‘Can I be hit by a vehicle? Is the scene a confined space? Do I have to worry about getting too cold or too hot? Can I fall?’ The assessment of hazards will depend on the scene and should be discussed with all parties involved.
Biological hazards are a major concern in any nonlaboratory setting. Blood may be fresh and un-confined. The risk of splash on the face or skin is high. The floor may even be slippery with blood. There may be other hazards not encountered in the laboratory. In an outdoor scene, animal feces can harbor fungal and bacterial infections, such as ‘valley fever’ from concentrations of bird droppings. Deer ticks can spread Lyme disease. Some spider bites cause serious illness or death. Use a rapid assessment of attendant risks to guide choices for clothing, assisted ventilation and individual roles of available personnel.
Autopsy
The autopsy occurs in a controlled setting with safety precautions generally in place. However, attendants at autopsy need to be aware of the risk of infection, not only from contact with blood but also from inhaled airborne particles. Saws can generate parti-culates that carry infectious fomites. Tuberculosis is spread by airborne nuclei and is a risk at autopsy or when moving a body at a crime scene, when airborne particles may be forced from the lungs. Any work with the brain or central nervous system may carry the increased risk of Creutzfeldt-Jakob disease (CJD). The causes of this disease, protein-based prions, are highly resistant to normal sterilization techniques.
Fire scene
Fire scenes carry the normal hazards of a typical crime scene, but the added danger of what is often a highly uncontrolled environment. Firefighters may be aware of these dangers, but the forensic scientist with little fire scene experience may not. Before entering the scene, check that the electricity has been made safe (usually it is switched off at the source) and that other utilities (gas and sewerage) will not pose a hazard. Other hazards include holes in the floor, danger of a structural collapse and wires poking out at eye level. For those who attend many fire scenes, unprotected breathing of airborne gases and dusts, such as charcoal dust, may cause long-term health problems.
Clandestine laboratories
The major hazard at a clandestine laboratory is the use of flammable liquids by miscreants who are not fully aware of their dangers. The atmosphere in the laboratory may be a fire or explosion waiting to be ignited. At dangerous exposure levels, inhalation of the vapours may result in disorientation, possible loss of consciousness, or caustic insult. Ignitable catalytic metals may also be present. The drugs, reactants and byproducts may be present in the air, or on many surfaces, creating risks for contact or inhalation intoxication. Other possible hazards may exist, such as deliberate traps designed to hurt or kill unwanted intruders. Investigators should be adequately trained in the use of respiratory protection, chemical-resistant suits and appropriate gloves. Each laboratory is unique and may require confined space considerations due to poor ventilation, limited egress or hazardous atmosphere.
Sources of Information, Guidelines and Law
The standards to be met in safety program design and application must meet the requirements of many different agencies. In addition, the forensic laboratory exists in a jumble of regulations, policies, legislation, case law and voluntary guidelines. These must be synthesized to make the local application practicable for the laboratory employee, yet bulletproof to scrutiny from an agent of one of the various bodies named above. As a rule, any single approach that we could recommend for laboratories would constitute ‘one size fits none’, so we will not attempt it. On the other hand, certain general principles for optimizing to meet local requirements apply to all forensic laboratories.
All laboratory procedures, policies and practices must meet applicable national, provincial, state, municipal and local legislation. There must be no gray area about which laws apply: consult your agency counsel, and those at the agencies higher on the food chain, to insure that you are aware of them all. Remember also that formally promulgated rules and regulations of the government have the legal weight and enforceability of law. Therefore, compliance is not optional for these rules and regulations.
You should ask other forensic laboratory administrators in the same or similar situations which laws they feel they must meet. Insure that your laboratory is compliant if your situation cannot be legally differentiated from theirs. Research case law that has developed in your jurisdiction as a result of worker exposures, injuries or fatalities. Understand the cause of the actions and the specific wrongful acts of management addressed through the court’s findings. A call to attorneys involved, public or employee advocacy groups and union representatives for your staff (if applicable) will help round out the story. There is no better way to avoid the problems of the past than to ask those involved on both sides. From these stories you must learn which legal interpretations have been wrong in the past, or specific actions and policies required to meet legal intent.
Local policies related to safety from your laboratory’s host department and agency should be reviewed as well. However, these do not bear the weight of law, and often have not necessarily been subject to the same rigorous deliberation before implementation. This makes them more negotiable should you find incongruence with legislative, case law or regulatory requirements. When you find incompatibility, you must comply with laws and regulations. Insure that your program complies with all applicable portions, and document your reasoning if you should find it necessary to not comply with any portion of the local policy.
In industrialized nations, safety and health have not been in the purview of ‘voluntary processes’ for some time. Owing to employer ignorance, disregard and past abuses, most forensic laboratories must be compliant with strict legal requirements as outlined above. However, voluntary programs may provide guidance to the laboratory in fleshing out the safety and health program, to improve it beyond the level of the legal standard.
Virtually all of the accreditation organizations in forensic science - including the National Association for Measurements and Standards (NAMAS, UK); National Association of Testing Authorities (NATA, Australia); Standards Council of Canada (SCC), American Society of Crime Laboratory Directors/ Laboratory Accreditation Board (ASCLD/LAB) and American Board of Forensic Toxicologists (ABFT) -incorporate essential elements in their accreditation criteria governing laboratory safety and health. Specific guidance for meeting these essential criteria may be obtained in the documents provided to applicants by the organizations. Updates and specific changes to the interpretation of these criteria are provided in the organizations’ newsletters and proceedings.
In addition, organizations such as the International Organization for Standardization (ISO), British Standards Institution (BSI) and American Society for Testing and Materials (ASTM) may come to mind when considering the availability of consensus standards for safety and health in the workplace. You may consult model documents from international and national trade organizations specializing in scientific workplace safety and health, such as the National Safety Council. In addition, the American Chemical Society and other national scientific organizations provide training programs for laboratory safety workers and managers, as well as implementation advice and training in risk assessment. Most of these programs are designed to insure compliance with ‘current Good Laboratory Practice’ (cGLP) standards, upon which rests the commercial laboratory’s ability to compete in the international marketplace.
Forensic laboratories are not usually considered in this competitive sense, but the forces of privatization at work in the United Kingdom and Australia may be harbingers for such conversion of forensic infrastructure in other countries. Therefore, laboratory managers and safety and health officials should at least be informed of the availability of such standards and training programs from commercial sources, and the role they serve in meeting competitive industrial requirements for free trade.
Policy Content
The manual of safety and health for a laboratory often matches the personality of its leadership and safety advocates. Some create massive safety tomes containing details ranging from imperatives to the trivial. Others take the short road and create policy manuals that fulfill legal requirements and provide reasonable but brief guidance on meeting a stated policy for health and safety maintenance without undue prescription. Your policy will be a personalized work, but recognize that the greater the level of detail, the faster the obsolescence and greater the requirement for routine scrutiny and update. But you must have reasonable detail so that staff members can understand and comply with the law.
As you develop your manual, here are some section headers routinely included in laboratory safety and health policy manuals. Modification will be made to fit your own situation, as ‘one size fits none’ is not our intent:
• Employers’ statement of intent: A brief summary of the necessity for, and management support of, the policies in the manual.
• Towers of the safety officer: Assignment of responsibilities and authority to the safety officer and committee members for issuing recommendations and monitoring compliance.
• Employee responsibilities: Assignment of responsibilities of employees in fulfilling elements of the policies and specific reporting requirements.
• Program for new employees: Specific elements of training and familiarization which must be completed before release of new employees to perform laboratory work.
• General guidelines: Overall program of safety, often including personal protective devices, physical plant elements of safety and health, update and maintenance procedures, reporting mechanisms and procedures for requesting policy clarifications and changes.
• Specific hazards: Guidelines for insuring a safe and healthy laboratory environment when dealing with problems unique to the laboratory design, type of work, type of evidence or as otherwise dictated (see review of forensic hazards above).
• Material safety data sheets: Instructions for accessing and using the information in these important documents. (Note: the documents themselves are not usually contained in the safety manual.)
• Rewards and discipline: Specific administrative outcomes to be expected for compliance with, or disregard for, the policies in the safety manual.
• Record-keeping requirements: Procedures for routine review, update, change and historical archiving of the manual.
Clearly, the laboratory will add other sections to the manual, and modify the content of each, as dictated by consideration of law, organizational requirements and the needs for continued improvement. Let history be your teacher.
Implementing Health and Safety Programs
To be effective, the program of health and safety must become integrated in the fiber of daily life at the laboratory. It is not enough to have excellent manuals on the shelf and records that demonstrate that employees have read and understand these manuals. Getting the staff to think of safety first in all procedures can become a test of wills. It is human nature to concentrate on the rush case, the broken instrument or the persistent pathologist’s question. Should you expect true understanding and unerring compliance? In a word, no. But you can build a series of rewards and punishments that will provide reasonable motivation to all employees to think and act safely, and construct a paper trail of appropriate responses when the odd staff member continually refuses to comply.
Never forget that safety starts at the top. The laboratory director, managers and supervisors have the legal and moral responsibility for insuring the availability of a safe and healthy workplace for everyone. Therefore, the job descriptions, goals, objectives and performance measures for each of these staff members must specifically set forth this duty. For example, supervisors’ objectives could include:
• Through his or her own action, demonstrates appropriate behavior to meet all requirements of the laboratory safety and health program.
• Through proactive measures, insures compliance among his or her staff with all requirements of the laboratory safety and health program.
• Performs routine safety audits of his or her own unit, and other units as assigned, and performs appropriate follow-up and reporting as required by the laboratory safety and health program.
• Appropriately rewards compliance, or performs disciplinary action related to noncompliance, with the laboratory safety and health program by subordinate staff members.
In addition, all employees should have at least the first of these sample objectives included in his or her documented duties. Performance against these objectives becomes a normal part of the process by which management evaluates employees. Be fair in this evaluation, and reward significant compliance and proactivity when they are observed. Positive reinforcement of proper action, and contributions to the improvement of the health and safety program, must be documented and rewarded. Make a point of catching staff when they do something right, even if the reward in such cases is only a quick note with a copy in the file.
A pattern of noncompliance should lead to corrective action, and continued noncompliance thereafter should be approached using progressive discipline. The hard part of this equation, as with any objectionable behavior, is determining when a behavior constitutes a pattern. The watchword is to be consistent, and document your actions.
In addition to the measures listed above, various strategies may assist the acceptance of the program by staff. Holding a safety fair or safety Olympics, posting safety-related information on a bulletin board, making safety discussions part of all continuing education programs, and generally keeping safety in front of everyone’s nose as often as possible will help. However, the single most effective way to capture and keep the laboratory focused on safety is to regularly audit against established standards of practice. The adage ‘What gets measured gets done’ is never more true than with safety.
The standards for audits are the safety manual and its interpretive discussions. Audits should be performed monthly, using checklists for ease and consistency of evaluation, and should be performed by supervisory staff on their own and each others’ units. Training for auditors should be included in skill development sessions with all supervisors. This training should also be structured to allow supervisors to evaluate and assess potential risks, using previous incidents and near-miss reports for guidance.
