To Whom It May Concern,  I am very concerned for your health and the
others also. In the case of safety and as a laboratory manager myself I
would appreciate someone pointing out that there is a safety problem in
the laboratory. If you do it in a tactful manner, "I am concerned about
a few safety issues in the laboratory such as use of an open flame
during embedding and personnel not using gloves during frozen sections,
could you please clarify the hospital/clinic/university's rules on
these issues for me as I want to make sure I am following
regulations".  " If you are open to a suggestion on the open flame
issue we used..... in our old laboratory which worked very well and
presented less danger to the technicians"  In stating things this way
you are not a tattle tale but you are informing the manager of your
concern for following the rules.  The following you may use as backup
information if you like: First is your laboratory CAP or JCAHO
regulated? If so these are the rules that are being broken, these are
some of the written guidelines from the CAP checklists, if your lab
received more than three Phase II deficiencies the CAP can shut you
down until you are in compliance (usually they will allow you a
probation time within which you must come into compliance):  Under
laboratory Safety CAP guidelines concerning proper use of personal
protective equipment (<bold>gloves issue)</bold>:  Phase II 01.7105
Have personnel been instructed in the proper use of personal protective
clothing/equipment (e.g., gloves, gowns, masks, eye protectors, etc.)? 
Phase II 01.7095 Does the laboratory have a documented policy for
infection control that complies with the OSHA standard on occupational
exposure to bloodborne pathogens and to the hospital's exposure control
plan?  The OSHA Bloodborne Pathogens standard under Universal
Precautions states:  1. Barrier protection at all times (for blood,
body fluids, tissue)  2. Gloves for blood, body fluids and tissue  It
goes on to state that the proper protective equipment must be worn
during procedures which involve possible exposure to blood, body fluids
and tissue.  Therefore it is necessary to wear gloves during frozen
sections due to possible exposures to Aids, Hepatitis or TB.  Phase II
01.7265 Have all personnel been instructed in the proper use and care
of disposable gloves, including: 1. The need for properly fitting
gloves, and 2. The need to replace gloves immediately when torn or
contaminated, and 3. The need to avoid washing of disinfecting gloves
for reuse, and The availability of hypoallergenic gloves, based on
patient and healthcare provider history?  Phase II 01.7270 Do personnel
use the proper personal protective devices when handling corrosive,
flammable, biohazardous, and carcinogenic substances?   Tissues
especially fresh tissue is considered a biohazardous material and if
fixed is still both biohazardous and a possible carcinogen as
formaldehyde is classified as a possible carcinogen  <bold>Open flame
issue</bold>: Although there is not specific rule for not using open
flames it has become common laboratory knowledge that is a great hazard
due to the number of flammable materials we work with in the
laboratory. Therefore most laboratories have gone to using the forceps
warmers and using several pairs of forceps. The key is to make sure to
wipe off the forceps with gauze before placing them back into the
warmer to avoid carryover from one tissue to another and while one
forcep is warming you can be working with the other pair. We also do
cellblocks here and have only twice in the ten years I have been here
had carryover >from one tissue to another and the pathologist was able
to recognize this as an artifact.  I hope this is helpful information
for you. I am always concerned when I see others in our field putting
themselves at risk when there are ways to prevent the risk. Please feel
free to contact me any time if you have any further questions and if
your laboratory manager has any questions about this information I will
be happy to speak with him/her any time. I don't have all of the
answers but if I don't know I have a lot of wonderful people who may be
able to help.  Good Luck!  Sincerely, Lynn Gardner, HT(ASCP)
Supervisory Research Assistant III FC Blodi Eye Pathology Laboratory
University of Iowa  233 MRC Iowa City, IA 52242-1182 Phone:
319-335-7095 Fax: 319-335-7193