Saturday, April 27, 2013

27 April 2013 When there was no OSHA

Cassi Creek:  In the early 1970’s I returned to university to study what was then known as “Medical Technology,” later called Clinical Lab Science.  The program required a heavy biological science curriculum like a pre-Med curriculum.  However, it had been captured by the college of education and thus included a minor in education.  There was an absolute disconnect between the allied health students and the Ed school as they insisted we had to take courses that did not mesh well with our core curriculum. 
          I recall being asked to stop a lesson plan presentation, which was to be drawn from our primary concentration.  While all the kids wishing to become teachers had presented lesson plans that dealt with primary or secondary education course, I decided to do a presentation on collecting the necessary samples for a dark-field examination.  For the non-clinical and the younger clinical, that requires scraping syphilitic lesions. 
          Once in the actual clinical rotations we began to amass the minutiae of laboratory studies as performed in the late 1960’s.  We learned to prepare reagents that were not commercially available.  That included biological reagents as well as non-biological.  One of our Pathology Department heads insisted that the reagent for Prothrombin Times be made from cadaver brains.  Microbiological media was cooked in an in-house kitchen rather than bought from media manufacturers. 
          Pipetting was done with glass pipettes and mouth suction.  This included biological materials and all manner of chemicals including acids, bases, and even ether.  Chemistry assays were set up individual tubes along with controls and standards then reagents were pipetted to each tube while watching a stopwatch.  Enzymes were notoriously difficult and as students, we often set them up in duplicate hoping to get a valid result. 
          The chemistry section had a Technicon 6-60 which incorporated a flame photometer.  To comply with fire codes the gas feed line ran from the analyzer across the floor, out a window, and down three floors to a large tank chained to the outer wall of the hospital.  The flame photometer used acetylene and air.  Each morning, the students assigned to that bench were sent down the hall to light the instrument and obtain a stable flame while the actual lab employees waited down the hall, behind fire doors, for the students to report success or for the report of an explosion. 
          In my rotations, there was one other male student.  Both of us were recently returned from VietNam.  For some reason we became the default team to bring up the 6-60 if we were assigned to any of the Chemistry benches.  We once told the lab administration that we wanted flak jackets and steel pots when we had to bring up that instrument. 
          Radioactive tracers were being phased in for the earliest actual thyroid function tests.    Those, too, were handled manually through preparation and analysis.  That also included mouth pipetting. 
          In those days we ate, drank, and smoked in the labs.  Only the presence of highly volatile flammables stopped us from smoking.  Those reagents were often used in volumes sufficient to generate a fuel-air ratio that was ripe for detonation.  That would also have scattered biological materials –often samples for parasitology studies – throughout the lab. 
          We worked bare handed for the most part.  There were no facemasks unless we were working with Tuberculosis,  histoplasma, coccidiodes, or blastomyces.  I did manage to infect myself and possibly the other students in a microbiology class with the 1968-69 strain of influenza.  I was pipetting a suspension of 10 x 106 in saline, by mouth of course, when I sneezed.  Instant infection.  There may have been some protective immunity as a result of having had this same strain in 1969 while in VietNam.  If so, it was minimal. 
          There were no routine tests to identify the viral agent causing hepatitis.  Hep A and B were diagnosed primarily by history and disease course. 
          I survived a 33-year career in clinical laboratories of various size and function without acquiring any systemic pulmonary infection or any form of hepatitis.  I’ve watched the safety practices change for the better as OSHA and other regulatory agencies took notice of clinical labs. 

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