Having established the general criteria for creating the lesson plan, the lesson content for lab and personnel safety training should include the following titles and topics (note again that only a broad view of the lesson plan is presented for your guidance; you should add the specific details under each topic as necessary):

1. General Safety: This may take the format of a walk-through the lab, hallways and floor on a lecture-demonstration tour to cover general injury and accident prevention topics like:
   • Electrical safety (no tangled cords on the floor, no overloaded outlets, no flammables near outlets, etc.)
   • Fire safety (fire alarms, fire extinguishers, exit routes).
   • Equipment locations and safety.
   • Personal protection equipment (apparel, gloves, eye wear, etc., and their location, proper selection and use).
2. Basic Lab Safety: Review the basic information you would want all lab users to know. Introduce the Stanford health and safety policies and practices as presented in Stanford Safety Manual (March, 1993) and Stanford School of Medicine Environmental Health and Safety Training . You may also wish to review the Safety Training Information flier. The topics should include:
   • Reminder to attend the Laboratory Safety Training seminar.
   • Importance of safe work practices in injury and illness prevention and as a regulatory requirement.
   • Health and safety system, and contacts, within the University, and within your lab, Department and School.
   • Brief commentary on some old practices vs. new and emerging attitudes and awareness in lab work practices, vis-a-vis health and safety consciousness and environmental concerns.

   OSHA Laboratory Standard. OSHA recognizes that laboratories generally contain many hazardous chemicals and other material and that risk assessment for all of them by lab supervisors could be prohibitive. OSHA, therefore, created a generic standard to encourage good laboratory practices. To ensure safety, the minimum requirements of the Standard are:

   • A sign, with the phone numbers of the emergency personnel, lab supervisor and lab employees must be posted in the lab.
   • Labels must be placed on all containers and waste receptacles to identify their contents.
   • Signs for the locations of safety shower, eye wash and other safety and first aid provisions.
   • Exit signs.
   • Sign to mark the areas where storage and consumption of food and beverages is permitted within the lab.
3. Chemical Safety : Stress the importance of observing the University's Chemical Hygiene Plan , and the fact that most accidents, audits and inspections take place, and citations issued, due to failures in this area of health and safety compliance. The chemical safety training should include:
   • All lab workers must be informed of the potential chemical hazards in the lab and appropriate safety precautions.
   • Familiarity with the Chemical Hygiene Plan and principles of chemical safety - labeling, handling and proper storage.
   • Material Safety Data Sheet (MSDS) maintained in a binder and a sample MSDS reviewed for the types of information it contains. EH&S maintains a MSDS database and a hard copy binder for 300 most commonly used chemicals at Stanford.
   • Periodic inventorying and segregation of chemicals in storage when requested by EH&S.

   A copy of the University's Chemical Hygiene Plan , a poster summarizing the Plan, Stanford Chemical Inventory Guide , and training schedules on various chemical safety topics offered by EH&S can be obtained from your Department office, or from EH&S by calling 5-1470.

4. Bloodborne Pathogens and Biological Safety: Stanford defines a biohazardous material as any infectious or pathogenic agent of bacterial, fungal, viral, rickettsial or chlamydial origin, bloodborne pathogens, and Other Potentially Infectious Materials (OPIMs) of biological origin. All labs and clinics working with biohazardous agents and certain categories of recombinant DNA research must submit a registration form to the University's Administrative Panel on Biosafety. The training on this topic should include:
   • Registering lab staff with potential for exposure to human blood or OPIMs with SU EH&S (3-0448).
   • Maintaining an up-to-date inventory of biohazardous agents in the lab.
   • Information on the inventory of biohazards in the lab, and risks and precautions in working with them.
   • Displaying universal biohazard and other warning signs in appropriate locations in the lab.
   • Ensuring that the use of the biohazardous agent/s and related protocols have been approved and are on file.
   • Appropriate hazard handling practices, protective equipment and emergency procedures are in place and communicated.
   • Ensuring that the labeling, storing and containment facilities are in compliance with the Biosafety Program Manual .

   The safety training for protecting workers from potential exposure to bloodborne pathogens (e.g., HIV and hepatitis B viruses) and OPIMs (which include most body fluids other than blood) are basically the same, with the following main additional requirements for training and communication:

   • Follow Universal Precautions in personal practices (hand washing, using protective barriers, e.g., appropriate gloves, and preventing penetrating injuries) and environmental controls (e.g., use of biosafety cabinets).
   • Work practice control is a preferred method of reducing hazards associated with bloodborne pathogens and OPIMs and includes prohibiting practices such as mouth-pipetting and recapping hypodermic needles, and practicing routine decontamination of work areas at the conclusion of a procedure.
   • Provide for free Hepatitis B vaccination , and obtain a signed declination from workers who decline the offer.
   • Medical follow-up for workers who have an exposure episode.

   For additional information on the Biosafety training, waste disposal and Bloodborne Pathogens, contact Biosafety (5-1473).

5. Radiation Safety: All Stanford personnel are required to complete a formal training in radiation safety prior to handling radioactive materials. If an employee has received formal training before, it must be documented. The course at Stanford covers the essential information on radiation physics, standards and regulations, bioeffects, protection measures, and monitoring of radioactivity in the work place.

   If the work in your lab involves use of materials or devices, including lasers, which pose radiation hazard, you should contact the Health Physics at 3-3201, and your Department should request for a copy of the Radiation Protection Manual.

6. Laboratory Waste Disposal: Laboratory waste from your lab will generally fall into one or more of the following four catagories:
   • chemical waste
   • biomedical waste Hazardous Wastes
   • radioactive waste, and
   • General (solid) waste.

   The first three of the above are heavily regulated, with strict enforcement and significant penalties for non-compliance and improper disposal. PI has a responsibility to train the employees in ensuring that these three categories of wastes, considered Hazardous Wastes , from his/her lab are properly identified, labeled and stored according to regulations, and are in a condition which will allow for safe handling and disposal by EH&S personnel, as outlined below.

7. Hazardous Waste Management : Include in your lesson plan, and emphasize during training, the fact that regulatory agencies are particularly sensitive to violations of hazardous waste management requirements by businesses and institutions. Explain the practice at Stanford from start of waste accumulation in the lab to its collection by H&S personnel, with particular attention to the following topics:
   • Waste identification and classification by chemical, biomedical or radioactive category.
   • Labeling, with all five sections on the prescribed tag completed (take few tags to demonstrate during training).
   • Store and, if permissible for the waste class, accumulate waste in the labeled container for up to the specified duration (call EH&S at 3-0448 for maximum accumulation period), after which it should be picked up by H&S by prior arrangement.
   • Make sure that each container has its own tag, completely filled out, and the wastes are properly segregated and have secondary containers.
   • Check periodically for leakage, loose or missing caps/lid and funnels, instead of caps/lids, on containers.
   • Unless you have an established regular pickup schedule, fill out form SU-13 and send to proper EH&S office 30 days before the desired pickup date.
8. Emergency Preparedness: Consider the potentials for accidents and emergencies related to the work assignments in your lab, and, with the participation of the trainees, identify the more accident-prone steps in each assignment, including all equipment , and have an emergency plan ready to handle them. In California and the Bay Area, cabinets, shelves, gas cylinders and other unsecured heavy items, which could pose a serious threat to life in case of an earthquake , must also be checked. The emergency preparation should include the following:
   • Laboratory contingency and earthquake safety plans.
   • Hazardous material release response plan.
   • Anchoring or securing items over four feet tall (book and file cabinets, gas cylinders etc.), and having the book and glassware storage cabinets fitted with lipped shelves whenever possible to guard aqainst sliding forward and falling in case of an earthquake.
   • Emergency protocols and supplies.
   • Evacuation map and procedure.
   • Alarms and notification plan to alert other lab workers, and to inform fire and EH&S Departments in case of an emergency.

   Each building has its own emergency response plan which includes posting of emergency procedures and evacuation maps on the bulletin boards. Know and inform employees of your building's plan and consult the Stanford Safety Manual for more information.

   The Emergency Instructions summary card tells you what to do and who to call in immediately health threatening (e.g., medical emergency, chemical spill, fire or toxic gas release), and non-health threatening emergencies (medical accident, minor chemical spill), and in situations where you are not sure if it is the first or the second (e.g., earthquake, suspected fire, unusual odor). Have the trainees look at the summary card and review it with them.

   In concluding the Lesson Content section, it should be reiterated that in the above outline, the specific occupational risks, hazards and other training needs of your particular research have not been included. You alone can determine them and see to it that they are plugged in at appropriate places on your copy of the lesson plan before delivering the training.