The well-established “Hierarchy of Controls” is a system used to eliminate or reduce hazards in the workplace. Whether or not you’ve heard this term, if you work in the laboratory, you’ve been an active participant in this system of safety. The purpose of the hierarchy is to protect employees who work in hazardous areas (like labs) by implementing multiple levels of precautions. If you pay attention to the order, however, you might be surprised about the different levels you utilize every day.

The first and most effective level of control is elimination of the hazard. There is no danger to the laboratorian if the hazard is gone, but of course this control cannot be enacted in the lab setting. The hazards dealt with are the patient samples and the chemicals used in testing, and those must be dealt with in order to perform laboratory jobs.

The next control in the hierarchy is substitution. While the hazardous samples that are analyzed can’t be replaced, there are processes in the lab in which some hazardous chemicals can be replaced. For example, manufacturers offer xylene substitutes which are far less hazardous to employees but which serve the same function in many processes.

Engineering controls are next. These are physical barriers or the use of engineered equipment that separates the worker physically from the hazard. A good example of an engineering control is a Biological Safety Cabinet or a Chemical Fume Hood. Even a counter-mounted splash shield is an engineering control. These devices provide strong protection from the hazards in the lab provided they are used correctly.

Administrative Controls are policies and practices meant to alter staff actions and behaviors in order to increase protection. It may no longer seem necessary to have policies preventing mouth pipetting- who does that anymore? But in today’s labs we still need polices preventing eating, gum chewing, and the use of cell phones in the lab. Like it or not, these practices in their own way are just as dangerous to laboratorians as placing a lab pipette between your lips.

Believe it or not, the last control- the one considered the least effective and the last resort- is the use of Personal Protective Equipment (PPE). We all know staff needs to use PPE in the labs, but the next time you don your lab coat, think about it- this is the very last useful barrier between you and the hazards you work with every day. None of the other methods in the hierarchy could be implemented to protect you sufficiently, so the use of this final protection has become necessary. That should scare you a little, and it should make you realize how important PPE is for your safety. Fear doesn’t sound like it should be a good motivator, but in the case for using PPE in the laboratory, it’s not so bad. If all lab staff had enough fear of the pathogens and chemicals used mixed in with some knowledge about consequences of unsafe behaviors, overall PPE compliance would be better in every lab everywhere.

Our skin is a good natural layer of “PPE,” but it contains many holes and openings which can be routes of infection. Laboratorians have to cover those holes, and using PPE- gloves, lab coats and face protection – is the last method they have. Once that PPE is on, employees have to be careful about their behaviors as well. That means avoiding touching faces with gloves on, or it means disposing of PPE slowly and carefully so as not to disperse contaminants in the department. About 63 to 319 healthcare workers die annually from occupational exposures in the United States. Some of these exposures are unknown- in other words, no one realized it happened while at work- but most are preventable. Help your staff understand the importance of the Hierarchy of Controls. Enforce the use of PPE and keep laboratorians safe from all of the hazards they encounter every day.