Pharmacy Safety and Occupational Health: Fire Safety Perspectives

Objectives: To explore the occupational safety and health emphasis on fire safety policy and procedures in pharmacy practice as a new initiative in Saudi Arabia. Methods: It was a narrative review of pharmacy practice fire safety policy and procedures. Literature searched various databases, including PubMed, Medline, and Google Scholar. The search period is from the 1960s until 06 December 2023. The term is in full-text English and includes Case Reports, Classical Articles, Clinical Conferences, Clinical Studies, Clinical Trials, Evaluation Studies, Government Publications, Guidelines, meta-analyses, Observational Studies, Practice Guidelines, Randomized Controlled Trials, Reviews, Systematic Reviews, with Humans subject. All hospital or community pharmacy services are included in a search term. Besides, the National and international guidelines of general occupational safety and health in hospital practice. The committee of pharmacy occupational safety and health policy and procedures formulated and consisted of various expert members. The policy included fire prevention, Emergency Plans, Fire Protection, Safety conditions, and requirements for the pharmacy buildings and medication stores. Results: The fire safety of pharmacy practice policy and procedures in pharmacy practice had various benefits, such as fire safety risk assessment, Usage of fire extinguishers type per each fire at each section of pharmacy services, illustrate the fire safety equipment requirement for pharmaceutical warehouse and pharmacy buildings, and instruction prevention of fire and during fire incident. Conclusion: Fire safety as part of occupational safety and health policy and procedures in pharmacy practice is a new initiative in Saudi Arabia. They will improve the pharmacy safety measurement and better occupational safety and health. In addition, it encourages pharmacy staff to adhere to local and international occupational safety and health regulations and standards. Therefore, The pharmacy occupational safety and health emphasis on fire safety highly recommended policies, procedures, and related risk assessment analysis in the pharmacy businesses in Saudi Arabia.


INTRODUCTION
[3][4] At each location, there are multiple facilities for offices and furniture.Besides, the central pharmacy area had many medicines and chemicals, such as alcohol or sanitizers. [1]All those chemical materials are flammable, and the pharmacy services foundation should be considered.[12][13] The annual health insurance report of occupational safety and healthcare incidents discussed the number of fire incidents. [14]The report discussed is generally not specific to any healthcare organization.The authors are unfamiliar with any literature discussing fire safety in a particular pharmacy.
The current topic explores the occupational safety emphasis of fire safety policy and procedures in pharmacy practice.

METHODS
It is a narrative review of pharmacy occupational health and safety.The literature search was performed using PubMed, Medline, and Google Scholar databases about specific pharmacy practice accounting and financial system topics.The search period was from the 1960s until 06 December 2023.The searched terms were in full-text English.They included Full text, Case Reports, Classical Articles, Clinical Conferences, Clinical Studies, Clinical Trials, Evaluation Studies, Government Publications, Guidelines, meta-analyses, Observational Studies, Practice Guidelines, Randomized Controlled Trials, Reviews, Systematic Reviews, Humans, in the English language.The pharmacy services included inpatient, outpatient, or ambulatory care pharmacy, satellite pharmacy, extemporaneous preparation, repackaging units, pharmacy store, drug information center, and clinical pharmacy services.][17][18][19][20][21][22][23][24][25][26][27][28][29][30] That includes guidelines from the Ministry of Building, [6] the Ministry of Human Resources and Social Development, [31] the Ministry of Inferior (Civil of Defense), [10,[32][33][34] General Organization for Social Insurance, [14,35] The Ministry of Labor (USA), National Fire Protection Association (USA), [5,8,12,[36][37][38] Occupational Safety and Health Administration (USA), [17,[39][40][41] The National Institute for Occupational Safety and Health (USA), and the Institution of Occupational Safety and Health (UK).Besides some local and international quality management standards from CBAHI and Joint Commission with emphasis on Facility and Management Safety (FMS). [19,42]43][44][45][46] The pharmacy occupational health and safety committee comprises experts, clinical pharmacists, occupational safety specialists, and fire safety experts.The clinical pharmacist had taken more than ten national and international education courses about occupational safety and health.Some authors drafted the policy guidelines, and the other authors reviewed them.The occupational safety and health specialist and fire safety revised the draft.The policy included the fire safety risk assessment, Usage of fire extinguishers, the fire safety equipment requirement for pharmaceutical warehouse and pharmacy buildings, and instruction prevention of fire and during fire incidents.The Standards for Reporting Qualitative Research guided the reporting of the results of this review. [47]he search term methodology was done as follows: Search: (pharmacy

Fire prevention
Risk Assessments A Risk Assessment of each trust pharmacy/ drug store will be carried out at least annually.
A suitably qualified and competent person will conduct a Risk Assessment and will: 3 Identify potential hazards.
3 Identify any persons at risk.
3 Evaluate the risk and implement measures to remove, reduce, or control the risk to an acceptable level.
3 All identified safety risks will be documented, systematically analyzed, and prioritized for action as necessary.
3 All relevant staff should receive information on control measures, including policies, procedures, and protocols to minimize risk, and where appropriate, staff training is to be undertaken to reduce knowledge gaps.
3 The Risk Assessment will be in writing and made available to Authorized Inspectors on request.
3 The Fire Risk Assessment will be regularly reviewed and revised if significant changes to the premises, procedures, processes, equipment, or room use lead to new or increased hazards, invalidating the original assessment.

Safety equipment testing
At all pharmacies or drug stores, a record is to be maintained of safety equipment tests and checks, which should incorporate the following: Make trial tests and maintain fire alarm and detection systems, emergency lighting, and fire-fighting equipment.Document the date of the test or maintenance and who carried these out.Record the details of defects and action taken, besides the date defects were rectified and by whom.

Emergency Plans and Procedures
3 Suitable emergency plans and procedures must be provided for each pharmacy/drug store site.The plans are to be prepared concerning the premises Risk Assessment and set out, amongst other things, details of the action to be taken with persons in case of emergency, the procedure of evacuation, and the arrangements for calling the civil defense and informing them of any unique risks.
3 The plans must identify those persons who are responsible for supervising the plans and the entities and carrying out emergency plan drills.
3 When carrying out any emergency evacuation plans, pay attention to the needs of any individual who may suffer physical or sensory disability.
3 Methods and equipment should be made available for the safe evacuation of occupants of the pharmacy or drug stores.
3 Fire action notices complementing the emergency evacuation plans will be prominently displayed in critical locations such as fire alarm call points and staff rooms.
3 The principal points to be included in the fire action notice are the actions to be taken upon discovering a fire and hearing the alarm; these should be adapted or extended to suit an individual site.
3 Methods must be employed to ensure the safe evacuation of all persons without reliance on the assistance of the civil defense.

Fire Protection
The pharmacist should use the following elements to prevent a fire inside or around the pharmacy building.
3 The pharmacist should follow the guidelines and regulations of civil defense, Saudi Building Code 201, Saudi Building Code 801, Saudi Buildings Code 1102, national fire protection for fire protection and emergency evacuation plans for fire occurrences during storage of medications or medical supplies, transport, until the distribution of medicine.
3 Make an Analysis of risk to predict all expected risks related to fire incidence and how to avoid them.
3 Used the Fire alarm: through implemented sprinkles and warning wrinkles.
3 Make Fire audit: through regular inspection of the fire protection equipment and process, inspection of equipment before operations such as fire extinguisher.
3 Please share in the Fire investigation that is related to collecting the reasons for the fire to be removed before it occurred.
3 Report review through the regular safety report and key performance indicators to review the strengths points and weaknesses points of fire protection to resolve.
3 Update the Strategic planning by analyzing the policy and process and related successful or failed fire protection operations.

Fire types
There are various types of fire, as follows.
3 Type A: Fire is from sold materials such as wood, paper, cloth, and plastic.The pharmacist can use fire extinguishers, water or form or drug powder (ABC).
3 Type B: The fire is from a flammable liquid or gas material such as benzene, kerosene, or alcohol.The pharmacist can form CO2 and dry powder.It should not use a water fire extinguisher that will increase the amount of fire and distribute the fire.
3 Type C: The fire from electrical equipment, and the pharmacist might use dry powder or CO2 fire extinguisher.It should not use water or form fire that will increase the electrical activity shock to the pharmacist.
3 Type D: The fire from chemical substances such as sodium, potassium, and magnesium.The pharmacist should use a special fire extinguisher for those substances.
3 Type K: The pharmacist can use a blanket cover or net chemical fire extinguishers for the fire from cooking oil.

General Policy of Fire Safety
3 The person responsible for safety is obligated to allocate a file called (the Fire Safety file) according to the form prepared by the Civil Defense, the pages of which shall be stamped with the Civil Defense seal, and it shall be allocated to record the results of the monthly examinations and periodic tests of the means and equipment of fire-fighting, surveillance and alarm, their dates and the entities.And the list, its results, repair processes, and other data.
In addition, a portion of the file is also allocated for inspections and maintenance of the building and electrical installations.
3 When any accident or accident occurs that involves a high degree of danger, the safety official is obligated to attempt to isolate or stop the source of danger immediately, evacuate workers from dangerous places in the building, and inform the specialized civil defense center immediately to consider the action that must be taken.
3 Workers in drug stores must be trained in fire-fighting, first aid, and rescue in schools and national training institutes accredited by the General Directorate of Civil Defense so that the requesting facility endures the cost of the trainees and, in all cases, the number of workers and their nationalities must be proven.

Safety conditions and requirements:
Location and construction 3 The location of the pharmacy or drug store must meet the requirements of the relevant official authorities in the Ministry of Health, municipalities, and others.3 The building must be made of noncombustible materials and resist fire for no less than (2 hr).
3 It is not allowed to establish pharmacies and warehouses underground (basement), within gas stations, or near dangerous places (welding workshops, laboratories, and stores of chemical and radioactive materials).3 The area of the drug warehouse must be at most 1000 m 2 .

Ventilation and air conditioning systems
3 When choosing the locations of the external air intakes for the air conditioner, avoid being adjacent to places or sources at risk of fire. 3 The main ducts of the air conditioner must pass through vertical or horizontal corridors made of non-combustible materials as a fire-retardant unit, with appropriate openings with fire-retardant doors to facilitate maintenance procedures.3 When the air conditioning ducts for fireretardant walls and ceilings in a building burn, their resistance to fire must be at the same degree as that of the walls, and they must be closed with materials that have the same fire resistance as the walls and ceilings.For the pharmacy 3 The pharmacy is provided with the necessary number of manual fire extinguishers at a rate of one dry chemical powder extinguisher (12 kg) per (50 m), with a minimum number of (2) dry chemical powder extinguisher (12 kg) for each pharmacy, regardless of its small area.3 The pharmacy has an early fire detection device connected to red or blue external lighting and an external alarm bell that works when a fire occurs.

For drug stores
3 Warehouses must be equipped with appropriate manual fire extinguishers following the rates and minimums mentioned above.3 The warehouse shall be equipped with an automatic fire-fighting sprinkler network system, and an external nozzle network shall also be available (not less than two nozzles).
3 The warehouse is equipped with automatic and manual alarm systems.
3 Suitable water tanks must be provided to implement paragraphs (b, c).
3 The authorities responsible for the site (pharmaceutical warehouse) must submit a technical study that includes a complete plan for safety and fire-fighting equipment and equipment to the competent civil defense department for review and approval of the appropriate equipment after inspecting the site.
3 The manual fire extinguisher shall be under the specifications issued by the Saudi Arabian Standards and Metrology Organization.
3 Fire extinguishers are placed or hung in precise places and close to doors and exits, making them easy to reach and use when necessary.
3 Each extinguisher must carry operating instructions and the last filling and maintenance date.

For pharmacies
The necessary means of egress must be available, according to the area of the pharmacy, to ensure its evacuation within a period of (three minutes) in the event of an emergency (such as a fire, for example, God forbid).

For drug stores
3 It implements the instructions in the storage warehouse regulations issued by His Royal Highness, Minister of Interior, and Chairman of the Civil Defense Council.
3 It is not permissible to place or install any furniture, barriers, equipment, or anything that would reduce the width of the escape exits or hinder its use.

Additional requirements for pharmaceutical warehouses
In addition to the previous conditions, the following requirements must be observed regarding drug warehouses.
3 The warehouse must have all the safety requirements and conditions per what is included in the list of safety conditions in storage warehouses issued by the Civil Defense, taking into account following the specific storage method and preventing the mixing of reactive materials and that the materials are classified and stored under the supervision of specialized chemists.
3 The potential risks in the warehouse must provide the necessary first aid materials.
3 Carrying out any medical or chemical formulations inside warehouses is strictly prohibited.These facilities are designated to receive pharmaceutical containers and store them in preparation for distribution.
3 The warehouse storage area should be divided into a receiving and delivery area, a storage area with suitable shelves, and an isolated area for damaged and expired returns in the warehouse or pharmacy.
3 Administration offices (and services), bathrooms, and places attached to the warehouse must be separate from the storage area.

CONCLUSION
Fire safety as part of occupational safety and health policy and procedures in pharmacy practice is a new initiative in the overall performance of pharmacy safety measurements.It significantly improves the pharmacy occupational health plan, emphasizing safety management.The pharmacist should be aware of and implement the fire safety risk assessment, the Usage of fire extinguishers, the fire safety equipment requirement for pharmaceutical warehouses and pharmacy buildings, and instruction in fire prevention and during fire incidents.The occupational safety and health emphasis on the fire safety pharmaceutical care services policy and procedures are highly required for implementation and during pharmacy operations in Saudi Arabia.

Clinical Study, Clinical Trial, Evaluation Study, Government Publication, Guideline, Meta-Analysis, Observational Study, Practice Guideline, Randomized Controlled Trial, Review, Systematic Review,
International Journal of Pharmacology and Clinical Sciences, Vol 12, Issue 3, Jul-Sep, 2023