Książkę tę dedykuję mojej wnuczce Julii

© Copyright by Anna W. Kierczak, 2016

© Copyright by Wydawnictwo Lekarskie PZWL, Warszawa 2016

Wszystkie prawa zastrzeżone.

Przedruk i reprodukcja w jakiejkolwiek postaci całości bądź części książki bez pisemnej zgody wydawcy są zabronione.

Recenzent: prof. dr hab. n. med. Maciej Szmitkowski

Wydawca: Jolanta Jedlińska

Redaktor merytoryczny: Zespół

Producent: Magdalena Preder

Projekt okładki i stron tytułowych: Lidia Michalak-Mirońska

Projekt okładek do serii: Magdalena Kaczmarczyk

eBook został przygotowany na podstawie wydania papierowego z 2016 r., (wyd. I)

Warszawa 2016

ISBN 978-83-200-5243-5

Wydawnictwo Lekarskie PZWL

02-460 Warszawa, ul. Gottlieba Daimlera 2

tel. 22 695 43 21

http://www.pzwl.pl

Księgarnia wysyłkowa:

tel. 42 680 44 88; infolinia: 801 33 33 88

e-mail: wysylkowa@pzwl.pl

Informacje w sprawie współpracy reklamowej: reklama@pwn.pl

Contents

Przedmowa

Explanatory Signs and Abbreviations

Unit 1. GUIDELINES ON LABORATORY SAFETY

Unit 2. TEST PREPARATION AND PERFORMANCE

Unit 3. BLOOD STUDIES

Unit 4. URINE STUDIES

Unit 5. STOOL TESTS

Unit 6. BODY FLUID ANALYSIS

Unit 7. MICROSCOPIC STUDIES

Unit 8. LABORATORY GENETICS

Appendix 1. THE ENGLISH ALPHABET – PRONUNCIATION

Appendix 2. MATHEMATICAL SYMBOLS AND SIGNS

Appendix 3. VULGAR AND DECIMAL FRACTIONS

Appendix 4. UNITS OF MEASUREMENT

Appendix 5. BASIC LABORATORY GLASSWARE AND EQUIPMENT

Appendix 6. LIST OF 71 CHEMICAL ELEMENTS

Appendix 7. HUMAN BODY

Appendix 8. HUMAN SYSTEMS AND ORGANS

Key

List of Specialist Words and Abbreviations

Bibliography

Internet Sources

Footnotes

Rest of the book available in full version

Unit 1
Guidelines on Laboratory Safety

Task 1

Before you read the passage on the safety in a laboratory (Section 1), can you give a definition of safety? Do you feel safe while working in a laboratory? Share your opinion with other students if possible. Then, read the text and check if you were right.

1. SAFETY IN A LABORATORY

Safety in the performance of laboratory procedures is an essential part of quality assurance[1]. To achieve a safe working environment, it is crucial to recognize safety hazards. Areas of safety that have to be taken into consideration include biologic safety, electrical safety, chemical safety, fire safety, and radiation safety.

1.1. General requirements for personal safety in a laboratory area:

• Laboratories must restrict access to the laboratory area. Visitors to the laboratory must have knowledge of laboratory safety rules.

• Laboratory coats or gowns should be worn in the laboratory and should be completely buttoned up to reduce transfer of microorganisms.

• No eating, drinking, or smoking should occur in the laboratory area.

• Drinks and food should not be placed in the refrigerator used for laboratory items.

• Nothing should be placed in your mouth including pipettes, pencils, fingers, etc.

• No application of cosmetics should occur in the laboratory.

• Shoes should be worn – no open-toed shoes.

• Heat-resistant gloves must be used to handle hot glass.

• Always wear rubber gloves when working with patient’s specimens.

• Wash your hands with soap and water before leaving the laboratory area.

• People with contact lenses are advised not to wear them in the laboratory.

• Long hair should be tied back to avoid contaminated material or moving instrumental parts.

• Centrifuges should not be operated without covers.

• Glassware that is broken or chipped must be discarded properly.

• Decontaminate the laboratory area immediately if biohazard material is spilled.

Task 2

Read the text on the safety in a laboratory (Section 1) and answer the questions. If you are working in a group, discuss the questions in pairs.

1. Is laboratory a safe place to work?

2. Is there a free access to the laboratory area?

3. Do you remember the safety rules one should follow in a lab? Give some examples. Do you follow any of these rules when you work in the university laboratories? Which ones?

Task 3

Read the text above (Section 1.1) and find the phrases which mean:

1) zapewnienie jakości

2) bezpieczne środowisko pracy

3) rozpoznawać zagrożenia bezpieczeństwa

4) osoby, które noszą szkła kontaktowe

5) nie wolno pracować na wirówkach, które nie są przykryte

6) umyj ręce wodą z mydłem

Task 4

Complete the table by converting nouns into verbs or vice versa. Use a dictionary if necessary.

Noun

Verb

safety

refrigerate

discard

autoclave

handle

contamination

dispose

Task 5

Read the text carefully and put in the following missing words: a) risk, b) laboratory, c) urine, d) disposal, e) specimens, f) training, g) autoclaved, h) hazard, i) infectious, j) decontaminated.

Collection and processing of clinical 1) …………… is accompanied by a varying degree of 2) …………… of infection to hospital and laboratory personnel. These risks can be minimized by appropriate education and 3) …………… regarding safety risks and by the establishment and practice of safety procedures. 4) …………… of clinical specimens and other biologic waste generated during the processing of specimens in the laboratories, without decontamination, poses a serious public health 5) ……………. Since all specimens (i.e. blood, 6) …………… , faeces, body fluids, exudates and tissues) submitted to the laboratories are from hospital patients, they should be considered 7) ……………. Therefore, such specimens and their wastes should be properly 8) …………… or 9) …………… before disposal. This also applies to all cultures generated in the microbiology 10) …………… .

Task 6

You will read a passage on the safety in a clinical or microbiology laboratory (Section 2). What could be the most common causes of laboratory accidents? Does laboratory safety depend on the personnel? What are the basic precautions necessary to prevent the spread of: a) bloodborne pathogen, and b) airborne pathogen to laboratory personnel?

Read the text below and check if you were right.

2. SAFETY IN THE CLINICAL OR MICROBIOLOGY LABORATORY

Any clinical or microbiology laboratory is a potentially hazardous place. However, it is the attitude of the personnel that makes a laboratory a safe or unsafe place to work. It has been established that ignorance and carelessness are the two of most common causes of laboratory accidents. Studies of laboratory-associated infections have indicated that most such infections do not result from known exposures and accidents but instead from routine handling of biologic or patient specimens.

The following rules together with the general rules listed in section “General Requirements for Personal Safety in a Laboratory Area” should be the norm for all clinical or microbiology laboratories:

• Laboratory and support personnel must have knowledge of the biological risks in the clinical or microbiological laboratory and act accordingly.

• Because of the special risks associated with AIDS, all clinical specimens should be treated as if they contain HIV. Latex or vinyl gloves should be worn whenever handling specimens of any kind.

• Masks must be worn any time there is a possibility of generating an aerosol during specimen preparation.

• Effective procedures for decontaminating infectious materials or wastes (i.e. specimens, syringes and needles, inoculated media, bacterial cultures, tissue cultures, experimental animals, glassware, instruments, and surfaces) must be in place and practiced without compromise.

• A 5,25% (full strength) chlorine bleach solution is recommended for decontaminating spilled infectious material.

• All potentially infectious waste must be burned in a certified incinerator or handled by a licensed waste handler.

• Personnel working with hazardous infectious agents or vaccines (e.g. rabies, polio, or diphtheria-pertussis-tetanus vaccines) must be vaccinated against the agent.

• Personnel working with human or primate tissue must be vaccinated against HBV.

• All pipetting must be done with automatic pipetting devices (not by mouth).

• Laboratory personnel must wear laboratory coats (and/or aprons), sealed shoes, rubber gloves, masks, eye protection, respiratory devices when needed, and other barrier protection as deemed appropriate by the level of exposure and the severity of the potential infection.

• Animals should be handled only by trained laboratory personnel.

• Anaesthetics or tranquillizers should be given to animals to avoid injury to both personnel and animals.

Task 7

“Airborne” means carried or transmitted by air (e.g. “Influenza is an airborne disease”). Can you give short definitions of “waterborne” and “bloodborne”?

Task 8

Analyse Table 1a and name the following chemical compounds:

1) BaSO4; 2) CuSO4; 3) Ag2S; 4) CuSO3; 5) AgNO3; 6) H2SO4; 7) H2SO3

In Appendix 6 you will find the names of chemical elements.

Table 1a Rules for naming acids and their corresponding salts*

Formula

Acid

Formula

Salt

HClO4

Perchloric acid

NaClO4

Sodium perchlorate

HClO3

Chloric acid

NaClO3

Sodium chlorate

HClO2

Chlorous acid

NaClO2

Sodium chlorite

HClO

Hypochlorous acid

NaClO

Sodium hypochlorite

HCl

Hydrochloric acid

NaCl

Sodium chloride

* New chemical nomenclature has been introduced, however the old one is still in use.

Task 9

Read the note below. Then, transform the following pairs of words into compound adjectives.

NOTE:

Hyphenated compound adjectives are often formed by:

• combing an adverb or a noun with a past participle: well-kept (secret), above-mentioned (reason), tongue-tied (witness).

• combining an adjective with a noun+ed: fine-grained (wood) or noun+d:blue-eyed (cat).

• combining a noun, adjective, or adverb with a present participle: bone-chilling (story), good-looking (man), long-lasting (paint).

Many of these compounds have become permanent hyphenated or solid compounds1, for example: well-known, tongue-tied, waterborne, bloodborne (or blood-borne), airborne, lightheaded, kindhearted, old-fashioned, open-toed, earsplitting, farseeing, etc.

See the task below (Task 9 A, B) as well as “Note”, p. 66.

A. Use the past participle or add -ed or -d to the appropriate word to form compound adjectives:[2]

a) heart; light .........................

b) age; middle .........................

c) wax; coat .........................

d) plate; silver .........................

e) mind; absent .........................

f) educate; well .........................

g) sleeve; short .........................

h) toe; open .........................

i) coat; sugar .........................

j) write; hand .........................

k) relate; patient .........................

l) code; colour .........................

m) base; alcohol .........................

B. Form compound adjectives; use the present participle (-ing form or continuous form) of the appropriate word.

a) reach; far .........................

b) consume; energy .........................

c) time; consume .........................

d) energy; give .........................

e) feed; breast .........................

f) hard; work .........................

g) wash; hand .........................

Task 10

Match these terms with the definitions:

Terms: 1) incinerator, 2) receptacle, 3) autoclave, 4) eyewash stations, 5) fire extinguisher, 6) sharps container, 7) refrigerator

Definitions:

a) A container that is filled with used medical needles and other sharp medical instruments, such as an IV catheter.

b) Object or place which receives and holds something, e.g. a plastic wastebasket in a laboratory.

c) Apparatus used for sterilizing by steam under pressure.

d) Boxlike appliance equipped with cooling apparatus, in which cool temperatures are maintained, used for the preservation of food and other perishables.

e) A furnace used to dispose of garbage or other waste material by burning it to ashes.

f) Apparatus containing chemicals for extinguishing fires.

g) Special device in a laboratory area where you can bathe your eyes. It is always ready for emergency use.

Task 11

Match the adjectives with their synonyms

1.

incinerated

a.

grouped

2.

hazardous

b.

chilled, cool

3.

batched

c.

marked, named, tagged

4.

disposable

d.

polluted

5.

contaminated

e.

able to withstand the action of

6.

refrigerated

autoclave

7.

soiled

f.

not-returnable, throw-away

8.

labelled

g.

burned, reduced to ashes

9.

infectious

h.

risky

10.

autoclavable

i.

stained

j.

capable of producing infection, containing disease producing microorganisms

Task 12

Read dialogue and answer the following questions:

1. Is Jack an experienced laboratorian?

2. Would you consider X-Y Laboratories a safe place to work with pathogens?

3. Do X-Y Laboratories offer any facilities for the stuff?

4. Where are Betty and Jack going to have their coffee?

Dialogue

Betty: Hi, I’m Betty Dean, a secretary to X-Y Laboratories. Are you Jack King, our new laboratory assistant?

Jack: That’s me. I’m Jack King and I’m hired as a microbiology lab assistant.

Betty: Welcome to our lab Jack, it’s nice to meet you. Is it your first job? Is there anything I can help you with?

Jack: Well, actually it is my first full-time job, but when I was a student I used to help professor Judy Brown in her bacteriological laboratory at the university. There was something I was wondering...

Betty: Yes?

Jack: Do you think you could show me around the laboratory area, if you have time?

Betty: Sure. Follow me.

…………

Jack: Five negatively pressurized rooms! Your laboratory is really impressive.

Betty: Oh yes, it’s really very modern and safe. If you handle hazardous pathogens, such as tuberculosis, AIDS or HBV your lab must be fitted with all these filters, safety cabinets, negatively pressurized rooms, and similar stuff to prevent any accidental release of pathogens from the laboratory. Now, Jack, I’m going to show you how the safety showers work.

Jack: Wow! They are great!

Betty: Yep, they are pretty effective… Let’s hope we’ll never need them!

Oh! It’s almost 10 o’clock – time for coffee break. Do you want to join me for coffee?

Jack: Great idea! But I haven’t seen a canteen or lunchroom on my way in.

Betty: We have them at the back, but there is a nice little coffee shop round the corner. Let’s go. I’ll pay!

Task 13

Translate into English:

1. Wszystkie próbki kliniczne powinny być uważane za potencjalnie zakaźne i potraktowane (= powinno się z nimi obchodzić) we właściwy sposób.

2. Umieść cały skażony materiał w pojemniku ze stali nierdzewnej.

3. Wszystkie pobrudzone i skażone fartuchy przednie, kitle i inne artykuły płócienne umieść w rozpuszczalnej w wodzie plastikowej torbie.

4. Wyślij wszystkie artykuły płócienne do pralni centralnej do wyprania.

5. Próbki zwierzęce powinny zostać odtransportowane do pieca w celu spalenia.

6. Kiedy plastykowe torby są pełne, zawiąż je mocno i oznacz etykietką.

7. Powinieneś zachować środki ostrożności przy próbkach krwi.

Task 14

Read the following safety rules. Put them next to the right rubrics in the table ted below.

1. Store acids and alkalis separately.

2. Wear a film badge to detect radiation exposure when working with radioisotopes.

3. Laboratory personnel should perform precautionary measures with patient specimens (blood, urine, etc.).

4. Have eyewash stations and safety showers available for emergency use.

5. Keep exits clear for emergency passage.

6. Post warning signs on entrance to the areas where radioactive material is used.

7. Check for proper grounding.

8. Do not expose open wounds to the risk of radioactive contamination.

9. Label chemicals.

10. Place fire extinguishers and fire blankets in conspicuous locations.

11. After emptying urine containers, the entire sink and surrounding area should be decontaminated with 5% sodium hypochlorite (Clorox, full strength) for 10 minutes.

12. Store chemicals in the following groups to prevent possible reactions: flammables, corrosives, toxic substances, explosives, oxidizing agents, water-sensitive chemicals, compressed gases.

13. Clearly mark breakers in the lab instrument circuits.

14. Place contaminated materials in “radioactive” waste receptacles and dispose of properly.

15. Be familiar with the proper use of fire blankets and fire extinguishers.

16. Small pieces of autopsied tissue or laboratory animals must be autoclaved in plastic bags (doubled) or metal containers. Specimen will be transported to the incinerator for incineration.

17. Be aware of the location of the circuit breaker box for emergency turn off.

18. Know the assigned fire emergency phone number.

Biologic safety rules

Electric safety rules

Chemical safety rules

Fire safety rules

Radiation safety rules

KEY

Unit 1: Guidelines on Laboratory Safety

Task 3

a) quality assurance

b) safe working environment

c) recognize safety hazards

d) people with contact lenses

e) centrifuges should not be operated without covers

f) wash your hands with soap and water

Task 4

Noun

Verb

safety

save

refrigerator

refrigerate

discard

discard

autoclave

autoclave

handle

handle

contamination

contaminate

disposal

dispose

Task 5

1e, 2a, 3f, 4d, 5h, 6c, 7i, 8j, 9g, 10b

Task 6

Possible answers

1. Ignorance, routine and carelessness of the personnel are the most common causes of laboratory accidents.

2. Laboratory safety depends on the personnel.

a) Bloodborne pathogen: see Section 2

b) Airborne pathogen: see Section 2

Task 7

Waterborne means carried or transmitted by water.

Bloodborne means transmitted by blood.

Task 8

1) barium sulphate, 2) copper sulphate, 3) silver sulphide, 4) cuprous sulphite, 5) silver nitrate, 6) sulphuric acid, 7) sulphurous acid.

Task 9

A: a) light-hearted, b) middle-aged, c) wax-coated, d) silver-plated, e) absent-minded, f) well-educated, g) short-sleeved, h) open-toed, i) sugar-coated, j) hand-written, k) patient-related; l) colour-coded; m) alcohol-based

B: a) far-reaching, b) energy-consuming, c) time-consuming, d) energy-giving, e) breastfeeding*, f) hardworking*, g) handwashing*

Task 10

1e, 2b, 3c, 4g, 5f, 6a, 7d

Task 11

1g, 2h, 3a, 4f, 5d, 6b, 7i, 8c, 9j, 10e

Task 12

1. No, he isn’t. He’s just starting his first full time job as a microbiology laboratory assistant in X-Y Laboratories. But when he was a student he used to help professor Judy Brown in her bacteriological lab at the university.

2. X-Y Laboratories are very modern and safe. They are fitted with special filters, safety cabinets, and negatively pressurized rooms to prevent any accidental release of pathogens from the laboratory.

3. Yes. They have a canteen and a lunchroom at the back.

4. They are going to have their coffee in a little coffee shop round the corner.

Task 13

Possible translations:

1. All clinical specimens should be considered potentially infectious and handled in the appropriate manner.

2. Place all contaminated material in a stainless steel container.

3. Place all contaminated aprons, gowns, and other linen in a water-soluble plastic bag.

4. Send all linen to a central laundry for wash.

5. Animal specimens should be transported to the incinerator for incineration.

6. When plastic bags are full, secure them tightly and label.

7. You should perform precautionary measures with blood specimens/samples.

Task 14

Biologic safety rules

3, 4, 11, 16

Electric safety rules

7, 13, 17

Chemical safety rules

1, 4, 9, 12

Fire safety rules

5, 10, 15, 18

Radiation safety rules

2, 4, 6, 8, 14

Footnotes

[1] Quality assurance (QA) is the set of planned and systematic actions necessary to provide appropriate confidence that service or product will satisfy the requirements for quality.

[2] Compounds may be classified as permanent or temporary. A permanent compound is fixed by common usage and can usually be found in a dictionary. Usually permanent compounds are solid compounds (two words written together). In general permanent compounds begin as temporary compounds (two words connected by a hyphen) that become used so frequently they become established as permanent compounds.

[3]  http://www.who.int/classifications/icd/ICD-10_2nd_ed_volume2.pd

[4]  http://www.szkolnictwo.pl/szukaj,Miedzynarodowa_Klasyfikacja_Chorob_ICD-10

[5] After Mosby’s Manual of Diagnostic and Laboratory Tests Fifth Edition, Elsevier Mosby 2014

[6] Australian Commission on Safety and Quality in Health Care. Draft National Safety and Quality Healthcare Standards. Sydney: ACSQHC, 2009

[7]Standards for Privacy of Individually Identifiable Health Information (The Privacy Rule) issued by The U.S. Department of Health and Human Services on December 2000.

[8] Phlebotomist is a medical professional who draws blood from patients for clinical or medical testing, transfusions, donations, or research. Many professionals, high school graduates or college students who plan to become nurses or doctors often start out by working in a medical office or hospital as phlebotomists. Since phlebotomy entails a fairly short training period, and because phlebotomist jobs are relatively easy to find and obtain, phlebotomy is a great way for someone to try out the medical profession. In Poland, the profession or position of a phlebotomist does not exist; venipuncture is performed by physicians, laboratory diagnosticians, nurses, laboratory technicians, and paramedics.

[9]  http://laboratory-manager.advanceweb.com

[10]  http://www.mayomedicallaboratories.com

[11] Gram stain, also Gram’s stain

[12]gram-positive, gram-negative, also Gram-positive, Gram-negative; G +, G –

[13]After Mosby’s Manual of Diagnostic and Laboratory Tests, 5th edition by Kathleen Deska Pagana and Timothy J. Pagana, Elsevier 2014, p. 774.

[14]After the National Human Genome Research Institute; https://www.genome.gov

[15] In English-speaking countries, a period (.) is used as the decimal separator, whereas in many other countries, especially in Europe, a comma (,) is used.

[16] 0 – w ułamkach dziesiętnych czytamy jak ‘nought’ [noot] lub ‘oh’ [oł].

[17] The English use the verb ‘starve’ (‘głodzić’) here. Polish speaking people say ‘pozbawiać pożywki’ if they speak about bacteria.