Safety in Medical Laboratories: Perception and Practice of University Students and Laboratory Workers

Abstract

Background:

Several safety-related accidents occur in the laboratories because of insufficient regulations, inappropriate implementation of safety measures, or unawareness attitude and practices toward safety precautions. Thus, establishment of efficient regulations and safe habits toward workplace safety is crucial to prevent or minimize such accidents. Here we investigate the levels of laboratory safety awareness among undergraduate medical science students and laboratory workers at major hospitals in Taif, Saudi Arabia.

Methods:

An anonymous cross-sectional survey was conducted on a random sample of 185 students and workers. The survey was categorized into five sections: (1) variable demographic items, (2) orientation around the warning signage of medical laboratory picograms, (3) assess participants' attitudes toward laboratory safety, (4) assess participants' safety awareness and practices in medical laboratories, and (5) assess participants' knowledge in dealing with emergency equipment and related procedures.

Results:

Data analyses indicate that workers are generally more aware of the key aspects of laboratory safety. Although students demonstrated moderate to good knowledge of major laboratory signage, there are some areas of deficiency, particularly regarding the use of fire extinguishers. Of interest is that female students are more familiar with laboratory signage than male students, although general laboratory safety awareness among students is poor. Students also showed poor awareness of certain critical aspects of safety practices and emergency procedures.

Conclusion:

The study data reveal inadequate awareness and knowledge of certain laboratory safety aspects among undergraduate students. Therefore, academic institutions should introduce effective safety regulations, education, and training to improve student safety.

Introduction

Teaching laboratories in academic institutions are where students develop experimental skills and expand their knowledge in certain fields of interest. Therefore, it is incumbent upon such institutions to ensure safety of students and employees. Previous studies have demonstrated the implementation of safety precautions and standards as being essential to high-quality educational and working conditions.¹ In general, academic institutions have made progress in minimizing the risk factors in teaching laboratories by introducing less hazardous materials and procedures and through supervised experimentation. Because of inadequate safety education, lack of regulation, and low awareness levels, there are undergraduate academic institutions where biosafety is still poorly organized and controlled.² It is estimated that there are 2.5 accidents per week in academic laboratories.³ A surveillance study, conducted by the Centers for Disease Control and Prevention, ranked laboratory incidents in educational institutions second among the industries studied, and a large number of injuries were those among students.⁴ Therefore, several countries have introduced Occupational Safety and Health Acts as guides for institutions to address safety issues.⁵

A variety of studies have been conducted worldwide, including the Middle East, to assess safety practices in chemistry, biology, and medical laboratories, in academic institutions and other health workplaces.^6–11 These studies indicate a lack of knowledge, and a misunderstanding of safety concepts, placing emphasis on increasing safety awareness through lectures, training, and other activities. Some studies recommend further in-depth research, with larger sample sizes, to collect more data to resolve this critical issue,¹² or to introduce safety education as an integral part of academic curricula.²

Students in medical laboratory programs undertake various practical sessions, including biochemistry, microbiology, hematology, histology, and parasitology. Therefore, students undertaking such specialty are in direct contact with various hazards, which increases the likelihood of exposure to chemicals or infectious agents, including blood-borne infections, if substantial safety measures are not followed accurately.^2,6 Thus, such studies are necessary to communicate the importance of safety to the organizations to help them managing biosafety by adopting approaches that prevent or minimize biohazardous risk^7,8

The objective of this study is to assess students' knowledge, attitudes, and practices concerning chemical and biosafety measures. Specifically, the study aimed to investigate the degree of safety awareness among students and how this awareness is influenced by the students' progression through the academic years. Another important aspect of this study is to investigate whether the current training, workshops, and courses are sufficient to improve the important aspects of laboratory safety among students. The data obtained from students were compared with data from laboratory employees working at two major hospitals. The purpose of including workers group to the safety study was to investigate whether a gap existed and how big is this difference between undergraduate students and those who have already graduated and are employed.

By evaluating participants' adherence to safety guidelines, through students' academic years and their internships, this study demonstrates the level of compliance with standard safety practices to assist the establishment of effective biosafety training programs for medical laboratory students. The acquired data may be significant for organizations that need to implement safety measures in teaching laboratories and medical facilities.

Methods

Study Population and Sample

The study received prior written ethical approval from the research ethics committee of Taif Health Affairs. Written informed consent was obtained from each participant before data collection. A cross-sectional analysis was conducted to assess laboratory safety knowledge and awareness. The target group of this study included medical laboratory students and medical laboratory workers at two major hospitals in Taif, Saudi Arabia. Data were recorded anonymously, and confidentiality was maintained; only the academic year, gender, and whether the participant was a student or an employee were known. Completed questionnaires were retrieved immediately by the researchers.

Participants were randomly selected for the study. Before distributing the questionnaires, the research objectives were explained, and participants were informed that they could voluntarily withdraw from the study at any stage. During data collection, a total of 142 students and 43 workers enrolled for survey participation. All data were collected from students under supervision of the researchers. Study participants were instructed to complete the questionnaire to the best of their knowledge, and to not consult one another, nor refer to the literature, while completing it.

Survey Questionnaire

A standardized structured self-administered questionnaire was adapted and modified from approved and published studies^11,13 (Supplementary Data S1 the questionnaire). The survey contained 43 questions, including closed- and open-ended questions, distributed across five categories. The first category consists of 10 variable demographic items, including gender, age group, academic year, previous laboratory experience, and safety training, the level of any safety courses completed, and whether the students have completed their field training (i.e., the internship). The second section is oriented around the warning signage of general medical laboratory picograms and is further divided into three parts. Part A includes nine different chemical hazard signs, part B includes five different biohazard signs, and part C includes types of fire extinguishers and their appropriate use according to fire type. The third section contains 5-point Likert-scale questions (1–5 scale) to assess participants' attitudes toward laboratory safety, based on the degree to which a participant agrees or disagrees with a statement.¹⁴ The fourth section contains five questions to assess participants' safety awareness and practices in medical laboratories: three Likert-scale (1–3 scale) and two closed-ended multiple-choice questions. The fifth section comprises five closed-ended multiple-choice questions designed to assess participants' knowledge and familiarity in dealing with emergency equipment and related procedures. In this section, multiple-choice questions 3, 4, and 5 were designed to offer participants the option of elaborating their answers under “other.”

The descriptive statistics were conducted by transforming the data into scores for the questionnaire sections, including warning signage awareness (i.e., comprehension of pictograms), knowledge, attitudes, and practices. For example, in section 2, part A, participants were asked to identify nine signs. A correct answer was assigned a score of 2, both an incorrect answer, and “I don't know the answer” were assigned a score of 0. The maximum achievable score was 18, and the knowledge levels were based on a modified version of the original Bloom's cutoff points¹⁵ as follows: 0–7 = poor, 8–13 = moderate, and 14–18 = good. For part B, the maximum score was 10, and knowledge levels were as follows: 0–4 = poor, 5–7 = moderate, and 8–10 = good. For part C, the maximum achievable score was 12, and the knowledge levels were as follows: 0–4 = poor, 5–8 = moderate, and 9–12 = good.

In section 3, the responses to statements used a 5-point Likert scale and the attitude score was calculated by assigning a rating of 5 to strongly disagree, 4 to disagree, 3 to neutral, 2 to agree, and 1 to strongly agree. The maximum achievable score was 25, and the knowledge levels were based on a modified version of the original Bloom's cutoff points as follows: 0–8 = poor, 9–17 = moderate, and 18–25 = good.

For section 4, a 3-point Likert scale was used to assess questions 1, 2, and 3, and the scores were distributed as follows: “always” was assigned 3, “sometimes” was assigned 2, and “never” was assigned 1. The maximum achievable score was 9. Another two closed-ended multiple-choice questions assigned a score of 2 to a correct answer and a score of 1 to an incorrect answer. Therefore, the maximum achievable score for the section was 13, and the knowledge levels were based on a modified version of the original Bloom's cutoff points as follows: 0–4 = poor, 5–9 = moderate, and 10–13 = good.

For section 5, a 3-point Likert scale was used to assess questions 1, 2, and 3, and the scores were distributed as follows: “Yes, I know” was assigned 3, “I know some” was assigned 2, and “No, I don't know” was assigned 1. The maximum achievable score was 9. Another two closed-ended multiple-choice questions were used to assess questions 4 and 5; a correct answer was assigned a score of 2 and an incorrect answer assigned a score of 1. The maximum achievable score for the entire section was 1, and the knowledge levels were based on a modified version of the original Bloom's cutoff points as follows: 0–4 = poor, 5–9 = moderate, and 10–13 = good.

Statistical Analysis

Retrieved questionnaires were coded and recorded into Microsoft Excel. Data were then exported to SPSS software (version 17, USA) to perform the data analyses and descriptive statistics. Levene's homogeneity of variance was checked when comparing groups and the scores were not significant, so equal variances were assumed. t-Test and one-way analysis of variance measured the association or correlation between demographic variables, and the awareness and practices of medical laboratory research groups concerning safety measures. A p-value of <0.05 was used as the cutoff for statistical significance based upon two tailed tests.

Results and Discussion

Questionnaire Section 1: Demographic Data

The demographic data of the research sample, including variables, frequencies, and percentages, are given in Table 1. The study targeted undergraduate students and medical laboratory hospital workers. The majority of the participants were students (n = 142, 76.2%), and the remaining were laboratory workers (n = 43, 23.8%). The demographic data revealed that 47% of the participants were men, whereas 53% were women. The student groups comprised 56.3% females and 43.7% males. The majority of participants (50.3%) were in the age group 21–25 years and 18.9% were aged 30 years and above, which represents the age of the laboratory workers. The age distribution of participants was relatively consistent with a previous study.¹³ However, the 26–29 years age group accounted for only 5.4%, which was anticipated and is justified by the fact that most of the students had graduated and were still seeking employment. Data were further classified by the students' academic year, with 26.6% of students in their second year. This classification was included to assess whether safety knowledge improves with students' academic levels. The data revealed that most participants had prior exposure to laboratory environments and had received safety training, of which laboratory workers represented 90.7%. This is because most hospitals continually provide workshops and training for staff, which are partly compulsory, to acquire training credits for either laboratory accreditation or for staff who need to renew their work permits or licenses. It has been found that the implementation of educational approaches for laboratory safety positively impacts safety awareness and knowledge among university students.¹⁶

Table 1.

Frequency distribution and percentage of participant demographics

Variable	Frequency, N	Percentage
Gender (all participants)
Male	87	47.0
Female	98	53.0
Gender (students)
Male	62	43.7
Female	80	56.3
Age group (years)
≤20	47	25.4
21–25	93	50.3
26–29	10	5.4
≥30	35	18.9
Academic year (students)
Year 1	27	14.6
Year 2	49	26.5
Year 3	30	16.2
Year 4	14	7.6
Year 5 (internship)	21	11.4
Students	142	76.2
Workers	44	23.8
Before your undergraduate studies, did you have any experience in a laboratory environment?
Yes	98	53.0
No	87	47.0
Have you ever received training about laboratory safety rules and procedures?
Yes	124	67.0
No	61	33.0

Questionnaire Section 2 (Parts A, B, and C): Assessment of Familiarity and Understanding of Chemical and Biohazard Warning Signage, and Fire Extinguisher Types and Usage

Various chemical and biohazard pictograms, as well as types of fire extinguishers and their proper usage, were included in the questionnaire for the participants to identify. The purpose of this section was to assess their familiarity with major medical laboratory and fire safety signage. More information about the questionnaire is available in the Supplementary Data S1 questionnaire. The data demonstrated that approximately half of the study participants (53.0%) exhibited good awareness and understanding of chemical warning signage, and participants with moderate to poor levels of awareness accounted for 31.4% and 15.6%, respectively. The data showed that, compared with students, workers have a good understanding of chemical hazard signage (84%), biohazard identification (83%), and the appropriate use of fire extinguishers (58%), as shown in Figure 1.

Figure 1.

Students' versus workers' knowledge and awareness levels toward laboratory warning signs: (A) chemical hazard, (B) biohazard, (C) fire types and extinguishers. Color images are available online.

Although laboratory workers' understanding of safety warning signage is greater, the data revealed that nearly half of the students have moderate to good understanding of chemical warning signage (44%) and biohazard signage (57%). This is not the case for types of fire extinguishers, which are essential equipment in laboratories, and the majority of students showed poor (28%) to moderate (55%) levels of awareness, as shown in Figure 1C. Previous studies have demonstrated a direct correlation between the lack of knowledge concerning both chemical and fire safety signage and the occurrence of laboratory accidents.^2,17 Based on the score classification, as explained in the Methods section, laboratory workers have significantly higher awareness levels (M = 15.07, SD = 4.54) than students (M = 10.05, SD = 5.20) concerning chemical signage (t(183) = −5.72, p = 0.001), and biohazard signage (t(183) = −2.66, p = 0.008). Whereas no statistical difference was observed between workers (M = 8.34, SD = 3.28) and students (M = 6.21, SD = 2.75) in fire extinguisher safety awareness (t(183) = −4.26, p = 0.07) (Table 2).

Table 2.

Descriptive statistical analysis of demographic variables for the warning signages and using the right fire extinguisher (questionnaire section 2)

Variables	Chemical signs (max score = 18)				Biohazard signs (max score = 10)			Fire extinguishers (max score = 12)
	N	Mean	SD	p	Mean	SD	p	Mean	SD	p
Gender (all participants)
Male	87	10.09	6.03	0.009	5.93	3.40	0.28	6.75	3.22	0.13
Female	98	12.21	4.70		6.47	3.33		6.67	2.82
Gender (students)
Male	61	7.93	4.99	0.001	5.38	3.49	0.12	5.85	2.85	0.20
Female	81	11.91	4.78		6.27	3.25		6.46	2.65
Gender (workers)
Male	26	14.23	5.72	0.59	7.23	3.15	0.86	8.63	3.23	0.22
Female	17	15.05	3.17		7.41	3.22		7.29	3.58
Academic years
Year 1	27	5.52	3.00	0.001	2.52	2.19	0.001	7.11	2.34	0.45
Year 2	49	10.82	4.88		6.29	2.77		6.00	2.67
Year 3	30	11.27	4.31		6.73	3.08		5.90	2.76
Year 4	14	7.57	4.72		6.29	4.14		6.00	2.77
Year 5 (internship)	21	14.82	4.65		7.73	3.10		6.00	3.36
All students	142	10.05	5.18	0.001	5.86	3.39	0.008	6.21	2.75	0.07
Workers	43	15.07	4.54		7.40	3.04		8.36	3.24
Have you ever received training about laboratory safety rules and procedures? (all participants)
Yes	124	13.58	4.78	0.67	7.69	2.64	0.02	6.71	3.14	0.11
No	61	10.25	4.75		6.13	3.22		6.69	2.75
Have you ever received training about laboratory safety rules and procedures? (students)
Yes	84	11.33	5.34	0.002	6.50	3.21	0.009	5.96	2.81	0.23
No	58	8.57	4.68		5.00	3.44		6.53	2.63
Have you ever received training about laboratory safety rules and procedures? (workers)
Yes	39	14.97	4.61	0.08	7.23	3.10	0.65	7.95	3.41	0.39
No	4	10.50	5.97		8.00	4.00		9.50	3.32

The undergraduate students in this study are separated by gender and take courses in different buildings under semiautonomous administration. Therefore, the variables in the safety questionnaire were analyzed by gender, with female students demonstrating the highest levels of good (50%) and moderate (45%) awareness, concerning chemical warning signage (Figure 2A). Most of both male and female students demonstrated good knowledge of biohazard warning signage, with both genders achieving ∼55% (Figure 2B). Higher practice scores for female students are consistent with previous studies,^13,18 suggesting that women are more aware of safety practice than men. Most students achieved only moderate scores in matching fire types to corresponding fire extinguishers, with 61% for female students and only 44% for male students. Approximately 20% of both student genders demonstrated a good understanding (Figure 2C). Based on the score classification, as shown in the Methods section, female students have significantly higher awareness levels (M = 11.91, SD = 4.78) than male students (M = 7.93, SD = 4.99) concerning chemical signage (t(140) = −4.82, p = 0.001). Whereas no statistical difference was observed for biohazard signage awareness between males (M = 5.38, SD = 3.49) and females (M = 6.27, SD = 3.25; t(140) = −1.57, p = 0.12) nor fire extinguisher safety awareness (t(140) = −1.30, p = 0.20).

Figure 2.

Comparison between student males' and females' knowledge levels toward laboratory warning signs: (A) chemical hazard, (B) biohazard, (C) using the right fire extinguishers. Color images are available online.

There is a significant difference between a student's academic year, and their awareness of laboratory hazard signage and fire extinguishers, as the data vary according to students' year of study. In general, the results showed a gradual increase in awareness levels with progressing academic years. This is highlighted by the inadequate responses of year 1 students to the questionnaire concerning the understanding of chemical and biohazard signage. Of the academic years, internship students showed the most accurate responses (Table 2). A similar finding by Walters et al. and Karapantsios et al. observed a direct correlation between students' safety knowledge and their academic level of study.^6,13 This observation may be attributed to the process of students' knowledge acquisition concerning safety through the years, which tends to increase adherence to good laboratory regulations and practices. Many students demonstrated moderate knowledge concerning fire types and the use of extinguishers, by achieving a score ranging between 6 and 7, out of 12 (Table 2). The negative response to fire signs may be attributed to (1) a lack of safety education, (2) minimal contact with fire extinguishers, or (3) the nature of medical laboratory research, whereby that students and staff are frequently exposed to chemical and biohazard pictograms, observed in their daily work in laboratories.

Questionnaire Section 3: Assessment of Attitudes Toward Laboratory Safety

Section 3 of the questionnaire was designed to assess the general attitude toward safety in medical laboratories. Statistical data for this section are given in Table 3 and in Supplementary Table S1. The analyses of students' data, based on gender, indicate no significant difference between female and male students (p = 0.192). Out of a possible score of 25, the males' mean score was 16.44 and the females' mean score was 17.85, which qualifies their attitude as a moderate level of awareness (Table 3). In this section, the general perceptions of students and workers were within average range. Although there is an observation of trending improvement in laboratory safety awareness from the first to the third academic year (Table 3), students generally achieve similar scores throughout the academic years of study, with third-year students achieving the highest mean score of 18.63.

Table 3.

Descriptive statistical analysis of demographic variables for safety attitude scores (questionnaire section 2, max score = 25)

Variable	N	Mean	SD	p
Gender (All participants)
Male	87	16.95	4.11	0.40
Female	98	17.76	3.36
Gender (students only)
Male	61	16.44	4.49	0.19
Female	81	17.85	3.37
Gender (workers only)
Male	26	17.69	2.39	0.57
Female	17	17.24	2.73
Academic Year
Year 1	27	16.33	3.23	0.20
Year 2	49	17.32	3.77
Year 3	30	18.63	5.46
Year 4	14	16.64	3.07
Year 5 (Internship)	21	16.52	2.67
All students	142	17.23	3.94	0.30
Workers	44	17.93	2.98
Have you ever received training about laboratory safety rules and procedures? (all participants)
Yes	124	17.20	3.48	0.04
No	61	17.78	4.24
Have you ever received training about laboratory safety rules and procedures? (students)
Yes	84	16.90	3.67	0.17
No	58	17.79	4.28
Have you ever received training about laboratory safety rules and procedures? (workers)
Yes	39	17.56	2.43	0.67
No	4	17.00	3.65

No significant differences are observed between the mean score of students and that of laboratory workers (p-value = 0.30). Importantly, there is a significant difference between participants with training and those without training concerning laboratory safety rules and procedures (p-value = 0.04), which implies the importance of training in medical laboratories. In this section, the accurate response to the statements is “strongly disagree.” Therefore, with the exception of workers' response to question 2, all participants' attitude toward laboratory safety is unsatisfactory, as their responses to the correct answers were <50% (Supplementary Table S1), whereby a high percentage responded with incorrect statements. Although workers in this section tend to correctly score higher percentage than students, it has been suggested that an organization's employees tend to be less concerned with safety if the risk assessment is inadequate, and, subsequently, the organization starts to accept higher risk as normal.² Furthermore, this issue has been recommended to be addressed through the creation of organizational safety culture, by strict risk assessment, emphasizing safety education, and conducting training sessions.¹³

Questionnaire Section 4: Assessment of Laboratory Safety Practices

This section of the safety study demonstrates moderate to good laboratory safety practices. There was little variance in the scores between academic years, and all years of study achieved a score of >10, out of a possible 13, except for year 1 students with a score of 9.56. As given in Table 4, there was no significant difference between male and female students (p = 0.57), but the data analyses showed a substantial difference between students and laboratory workers (p = 0.001).

Table 4.

Descriptive statistical analysis of demographic variables for laboratory safety practice scores (questionnaire section 4, max score = 13)

Variable	N	Mean	SD	p
Gender (all participants)
Male	87	10.63	1.86	0.50
Female	98	10.70	1.78
Gender (students only)
Male	61	10.13	1.97	0.57
Female	81	10.49	1.86
Gender (workers only)
Male	26	11.42	1.10	0.83
Female	17	11.35	0.86
Academic year
Year 1	27	9.56	1.48	0.02
Year 2	49	10.69	2.10
Year 3	30	10.67	2.06
Year 4	14	10.36	1.98
Year 5 (internship)	22	10.67	1.17
Students	142	10.34	1.91	0.001
Workers	43	11.75	0.781
Have you ever received training about laboratory safety rules and procedures? (all participants)
Yes	124	10.75	1.86	0.65
No	61	10.51	1.74
Have you ever received training about laboratory safety rules and procedures? (students)
Yes	84	10.29	2.03	0.70
No	58	10.41	1.73
Have you ever received training about laboratory safety rules and procedures? (workers)
Yes	39	11.33	1.01	0.21
No	4	12.00	0.82

The data in response to questions 1 and 2 indicate that the majority of students (60.6% and 60.5%, respectively) and laboratory workers (83.7% and 81.4%, respectively) always comply with good safety practices, including reading Material Safety Data Sheets before using new chemicals and wearing the appropriate personal protective equipment (Supplementary Table S2). The correct responses of students concerning proper ventilation, such as laboratory chemical hoods, were only 43%, compared with 69.8% of laboratory workers (Supplementary Table S2). Importantly, the data showed that between 2.1% and 16.9% of student participants never comply with any of the mentioned safety practices.

Concerning the appropriate disposal of chemical waste, the responses indicate that 48.6% of the students had a good understanding of the procedures and policies concerning laboratory waste, compared with 59.2% of students with only a moderate to good understanding of biological waste disposal. This finding may be explained by the nature of student specialties, whereby the understanding of medical laboratory staff and students concerning biological waste disposal is associated with a low risk of disease transmission. This is supported by research that finds a correlation between good medical and biological waste disposal, and a decline in the transmission of infectious diseases.¹⁹ For laboratory workers, the data showed generally adequate knowledge concerning chemical (74.4%) and biological (69.8%) waste (Supplementary Table S3).

Questionnaire Section 5: Emergency Equipment and Procedures

The descriptive statistics and data of this section are given in Table 5, as well as in Supplementary Tables S4 and S5. The demographic statistics showed a gradual increase in awareness among the study participants, with respect to emergency equipment and procedures, with the highest mean score of laboratory workers at 11.68. In general, the awareness of students and laboratory workers ranges from moderate to good, based on a total possible score of 13 (Table 5), and workers showed significantly higher awareness levels than students (p ≤ 0.001).

Table 5.

Descriptive statistical analysis of demographic variables for the emergency equipment and procedure scores (questionnaire section 5, max score = 13)

Variable	N	Mean	SD	p
Gender (all participants)
Male	87	9.76	2.35	0.09
Female	98	10.13	1.89
Gender (students only)
Male	61	8.90	2.28	0.43
Female	81	9.83	1.93
Gender (workers only)
Male	26	11.23	1.24	0.73
Female	17	11.35	0.86
Academic year
Year 1	27	8.67	1.39	<0.001
Year 2	49	9.59	1.94
Year 3	30	9.92	2.62
Year 4	14	10.14	2.82
Year 5 (internship)	21	10.90	1.44
Students	142	9.44	2.14	<0.001
Workers	43	11.68	0.71
Have you ever received training about laboratory safety rules and procedures? (all participants)
Yes	124	10.37	1.88	0.07
No	61	9.11	2.33
Have you ever received training about laboratory safety rules and procedures? (students)
Yes	84	9.74	1.94	0.04
No	58	9.00	2.32
Have you ever received training about laboratory safety rules and procedures? (workers)
Yes	39	11.40	0.99	0.44
No	4	10.50	1.91

Regarding the location identification of emergency safety equipment and proper usage, medical laboratory workers were highly familiar with the location (100%) and proper usage (93%) of emergency equipment compared with 23% and 12.7% of students, respectively (Supplementary Table S4). This significant difference in awareness between the two groups emphasizes the urgency of addressing this issue, either through incorporating safety awareness in core study curricula or through intensive training sessions. It is important to highlight, as given in Supplementary Table S4, the large percentage of students who indicated that they do not know the location of safety equipment (45.1%) nor proper equipment usage (37.3%). This finding implies the importance of implementing an approach for safety regulation, whereby students undertake mandatory testing for safety knowledge. Based on the outcomes, institutions should incorporate site-specific safety education throughout students' academic years. Mandatory safety education has been considered a part of the undergraduate curriculum by several leading universities in the United States.^16,20,21

Regarding biological and chemical samples, 97.7% of laboratory workers demonstrated a good understanding of spills in medical laboratories. Contrastingly, students showed low levels of knowledge, with 54.2% demonstrating less concern for policies and procedures that effectively deal with biological spill incidents. For spills that come into direct contact with the skin or eyes, the awareness of students increased markedly to 63.4% and 67.6%, respectively (Supplementary Table S5). These findings are aligned with a previous study that attributes this sudden awareness increase to two factors: first that university staff emphasize student emergency safety standard, and second that students are more concerned about safety information that directly affects their health.¹¹

Conclusion and Recommendations

This study was conducted to assess laboratory safety awareness among undergraduate students and medical laboratory workers in hospitals. A safety survey was conducted by assessing several laboratory safety aspects, including chemical and biological hazards. The statistical analysis of the questionnaire showed that, regarding laboratory hazards, the majority of student participants in this study did not respond well, although the data showed an improvement in awareness over academic years. Contrastingly, laboratory workers, as a reference point to compare the students, had responses ranging from moderate to good, regarding their attitudes and practices toward safety regulation compliance. Students and workers demonstrated a lack of usage familiarity with appropriate fire extinguishers, which are considered essential safety equipment in laboratories.

The low percentage of correct responses and safety attitudes among students emphasizes the need for improved safety regulations in academic institutions. Enhancing laboratory safety awareness among undergraduate students may be achieved by (1) implementing strict safety regulations, policies, and risk management in academic institutions; (2) introducing safety education as an integral part of academic curricula; (3) spreading safety culture and ethics in academic institutions through research, workshops, training, and compulsory online courses; and (4) involving students in safety practices through live demonstration and real, or simulated, laboratory risk assessment, thereby encouraging them to practice good safety measures during experimentation.

These steps are crucial to protect students, staff, and inclusive academic settings, as well as to prepare students as future employees. Graduates equipped with strong safety education and ethics are recognized by employers as fit candidates, either in the private or governmental sectors. The data from this study may provide valuable information for relevant academic and health industries.

Authors' Contributions

Both authors contributed equally to this article. The authors read and approved the final article.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

No funding was received for this article.

Supplementary Material

Supplementary Data S1

Supplementary Table S1

Supplementary Table S2

Supplementary Table S3

Supplementary Table S4

Supplementary Table S5