Understanding lab accident causation is key to preventing incidents and ensuring a safe work environment. In this Q&A, Angela Maria Casaril, senior research scientist and laboratory manager at MD Anderson Cancer Center, shares her expertise on conducting hazard analyses, addressing root causes of lab accidents, and encouraging staff to report near-misses. She provides actionable strategies for mitigating risks, improving safety training, and integrating continuous education to reduce lab accident causation and promote a safer, more efficient workplace.
Can you walk us through the steps of a hazard analysis in your lab? How do you ensure all potential risks are identified?
Every task has at least one potential hazard, and in the lab, multiple tasks are done at the same time by different people with unique experiences and backgrounds. This reflects the importance of risk management in the laboratory and the pivotal role of lab managers and safety specialists.
In our lab, a hazard analysis starts by gathering relevant documents and analyzing lab activities, including reagents and supplies, lab layouts, equipment inventories, standard operating procedures (SOPs), and safety data sheets. Lab incidents are caused by chemical, biological, physical, ergonomic, or psychosocial hazards, and we implement different tools to increase our chances of identifying them. For example:
- Physical walkthroughs allow us to observe workflows (which can also benefit lean 5S programs),
- Job hazard analysis focuses on each individual task/component of a procedure,
- What-if scenarios force us to determine what can go wrong in a given situation,
- and the just-culture algorithm helps us identify organizational errors.
It is also important to engage lab personnel to capture insights from their daily operations and near-misses. Including a multidisciplinary team that brings together different perspectives, expertise, and experiences ensures comprehensive risk identification and cross-functional awareness.
Once hazards are identified, we use risk matrices to determine the likelihood and potential impact of each hazard to prioritize high-risk areas for mitigation. From there, we implement administrative and engineering controls to address these risks, which include eliminating or substituting hazards where possible, introducing fume hoods and sharps containers, updating SOPs and clear signage, and always making appropriate personal protective equipment (PPE) available. All the processes and observations are documented for compliance purposes and data collection and shared with staff during meetings, training sessions, and newsletters. As for the last step, we monitor and review the safety measures through periodic inspections and feedback mechanisms to ensure that they remain relevant and to help us quickly identify new risks and implement continuous improvement strategies, keeping the lab adaptable to new projects and challenges.
How do you balance addressing immediate causes of incidents (e.g., human error) versus systemic issues (e.g., procedural flaws or equipment design)?
While every laboratory manager strives to have a zero-incident environment, I acknowledge that incidents can happen and use them as an opportunity for learning and prevention of future occurrences. To help address incident causes, we follow high-reliability organization principles by implementing the “Just Culture” algorithm. This framework helps categorize errors into three types of behavior, namely human error (a slip, lapse, or mistake), at-risk behavior (a choice, where the risk was believed to be justified or insignificant), and reckless behavior (disregard of substantial and unjustified risk). Focusing on the differences between these behaviors helps me dive into the root causes of incidents and implement corrective and preventive actions, which can include counseling and coaching, more comprehensive SOPs, workload distribution, process optimization to minimize inherent risks, and robust training.
What is your approach to incident investigations, and what tools or methodologies do you find most effective?
When an incident occurs, the initial priority is to ensure the safety of all personnel and address any immediate risks. Once the environment is secure, I begin by gathering information to establish a comprehensive understanding of the event, which includes documenting the incident location, time, and parties involved. One of the most important things to consider when investigating an incident is that even the most seemingly straightforward occurrence might have multiple causes. To identify the root cause of the incident, I believe the fishbone/Ishikawa diagram is one of the most effective tools because it forces me to investigate multiple categories as causes of the incident, including equipment, process, people, materials, environment, and management. After identifying the category (or categories) of origin, I like implementing the 5 Whys approach to get to the bottom of each contributing factor to uncover the underlying causes. I believe that a successful incident investigation will happen when you engage the team to gather different perspectives and knowledge from first-hand experience. Once the root cause is identified, I work to implement both corrective actions to address the immediate issue and preventive measures to ensure similar incidents do not occur in the future. In the end, I prepare detailed reports that outline the incident, investigation findings, root cause analysis, and corrective and preventive actions, and share these with the team to promote transparency and learning.
What strategies do you use to encourage staff to report near-misses or potential hazards without fear of repercussions?
The key to encouraging staff to report near-misses or potential hazards is by increasing safety culture and promoting a psychologically safe environment. To do that, we constantly emphasize that incidents can be an opportunity for learning instead of creating a blaming situation. It is very important to reassure them that the goal of reporting near-misses or potential hazards is improvement and not condemnation. We have also implemented a “safety moment” initiative, where at the beginning of meetings, we have a brief 15-minute presentation on success stories about incident prevention. In this scenario, leading by example plays a significant role, and sharing personal experiences with reporting near-misses or addressing hazards demonstrates a commitment to safety. We also regularly educate and train staff on best practices for incident prevention, especially when procedures are created or updated.
Additionally, I actively seek suggestions and feedback from staff on how to improve operations to reduce incidents. Ultimately, lab safety is a team effort, and this is a great way to empower them and promote a proactive safety culture where they feel valued and motivated to contribute.
How do you integrate ongoing education and training into your lab's culture to prevent accidents?
Education and training are integrated into our lab’s culture through a proactive and consistent multi-domain approach that starts from the first day in the lab. We have a comprehensive onboarding program for new members, periodic refresher courses, real-time coaching, and on-the-job training. We have also developed a centralized library containing safety resources, such as SOPs, manuals, and training material, that is readily accessible to all lab members. Importantly, we encourage feedback to make us review and reformulate the training program to ensure its relevance. We also leverage on-site and virtual training, webinars, and e-learning platforms from outside sources to increase our knowledge of equipment, materials, and procedures and consequently increase our safety awareness. Personally, I am also constantly seeking training, feedback, and suggestions as I strongly believe that leading by example helps nurture a positive and safe culture.
What final advice do you have for lab managers to help keep their staff safe?
I would like to emphasize that risk management and incident prevention are deeply rooted in having a strong safety culture where every team member values safety as a core responsibility and feels empowered to speak up about potential risks. Lab managers play a critical role in this by setting the tone and modeling safe behaviors. For this reason, they need to be adaptable and versatile and know enough about all lab operations to be able to provide guidance about the greatest risks in the lab.
Ultimately, a successful risk management approach should encourage continuous learning, collaboration, and open communication to drive inclusive and data-driven initiatives. Together, these efforts maintain cohesive and high-performing teams and ensure that the lab operates safely and efficiently while minimizing the risk of incidents.
Angela Maria Casaril is a senior research scientist and laboratory manager at MD Anderson Cancer Center where she oversees laboratory operations and regulatory compliance. With a PhD in biotechnology and an MBA in project management, she brings extensive expertise in implementing safety practices and training programs that foster a culture of safety and operational excellence. In addition to her managerial responsibilities, Angela serves as a project manager for research on chemotherapy-induced peripheral neuropathy and as a mentor for students. She is committed to continuous learning and leading her team to achieve their full potential. Outside of work, Angela spends her spare time completing jigsaw puzzles, running 5Ks outdoors, and volunteering at local gardens and animal shelters.