Emergencies, Exposures And Spills

Emergency Types

There are three types of emergencies:

• Disasters due to fires, floods and earthquakes
• Biohazardous spills 
• Spills which involve multiple hazards

 General Emergency Procedures

• Alert others
• Confine the problem (if possible without undue risk)
• Turn off ignition sources
• Leave ventilation on
• Evacuate, if necessary
• Close doors
• Call from a secure area
• Give name, phone number, location, type of emergency
• Remain near phone to assist responders

For more information please see Emergency Procedures.

Exposures and Injuries

The procedures, activities, personnel attitudes, and equipment that create conditions favorable for occupational laboratory infections are similar to those that lead to the occurrence of industrial-type accidents.

The extra ingredient is the presence of biohazardous agents capable of causing human infections. 

Laboratory events that might create hazards, exposures, or accidents requiring reporting could be classified in two categories:

• Events occurring during work with biohazardous materials or in a biohazardous area that could result in physical injury, cuts, burns, abrasions, or fractures.
• Events occurring during the handling of biohazardous agents, infected specimens, or animals that could allow release of the agent to the environment or its undesired transfer to employees, animals or cultures.

In the first category, the injury site could be contaminated with the biohazardous agent in use.  In the second category illness or unwanted cross-contamination could occur without physical injury. 

Mechanisms of infection typical of the second category are ingestion of contaminated fluids, exposure to aerosols, and penetration of agents through the unbroken skin.

Therefore, for the purpose of controlling biohazards, all accidents, known exposures, and potential hazards must be identified and reported.

Skin and eye contact

By direct contact with the skin or eyes, chemicals can easily enter the body resulting a local reaction, such as a burn or rash, or absorption into the bloodstream. If there is an absorption into the bloodstream, the chemical may cause toxic effects on other parts of the body. The SDS usually includes information regarding if skin absorption is an important way of exposure.

Health of the skin and the properties of the chemical influence the chemical absorption through the skin. The resistance of a skin, that is dry or cracked, is low. Organic solvents can easily penetrate skin which changes the resistance of the skin to other materials.

Gloves and other protective clothing should be worn to reduce skin exposure. Skin exposure shows symptoms like dry, whitened skin, redness and swelling, rashes or blisters, and itching. If there is chemical contact on skin, the clothes should be removed and the affected area should be rinsed with water. If symptoms continue, medical care should be taken.

If the eyes are exposed to chemicals, painful injury or loss of sight may be seen. Safety goggles or a face shield should always be worn to reduce the risk of eye contact. Eyes that have been in contact with chemicals should be rinsed immediately with Diphoterine or water continuously for at least 15 minutes and the contact lenses should be removed while rinsing. If symptoms continue, medical care should be taken.

Inhalation

Gases, vapors, particles, and aerosols (smoke, mists and, and fumes) can easily penetrate into the respiratory system and may be transported into the lungs or be absorbed into the bloodstream. The vapor pressure of the material, solubility, particle size, its concentration in the inhaled air, and the chemical properties of the material influence the absorption of these materials into the respiratory system. If the vapor pressure is high, this means a substance can quickly evaporate into the air and the concentration in air can increase. Higher concentrations in air cause greater exposure in the lungs and greater absorption in the bloodstream. As most of the chemicals have an odor, there is no relationship between odor and toxicity. There is considerable individual variability in the perception of odor. The odor may seem to disappear as fatigue may occur when the lab user is exposed to high concentrations of chemicals, but the danger of over-exposure remains. Headaches, increased mucus production, and eye, nose and throat irritation are included in the symptoms of over-exposure. In addition, many solvents may induce narcotic effects, including confusion, dizziness, drowsiness, or collapse. containers should be closed and the ventilation should be increased in the event of exposure. If symptoms continue, medical care should be taken.

To reduce the exposure capacity, volatile hazardous materials should be used in a well-ventilated area, rather a fume hood. Respirators should also be used in the case of inadequate ventilation and bad working fume hoods. The use of a respirator is subject to prior review by LS/LSS according to SU Policy. See Personal Protective Equipment for more information.

Ingestion

Toxic substances can also penetrate from the gastrointestinal tract. Chemicals direct ingestion may not be possible, but the lab user may be exposed to the chemicals by ingesting contaminated food or beverages, touching the mouth with contaminated fingers, or swallowing inhaled particles. Therefore, to reduce the possibility of this kind of exposure, users should not eat, drink, smoke or store food in the working area and hands should always be washed after working with chemicals, even when gloves were worn.

In the event of accidental ingestion, immediately go to Health Center or contact LSS for instructions. Do not vomit unless directed to do so by a health care provider.

Injection

Injection is the final possible way of exposure to chemicals. Syringe needles, handling animals, or accidents with pipettes, broken glassware or other sharp objects that have been contaminated with toxic substances may cause injection. Direct access to the bloodstream, thus, to internal organ systems is provided by injection.

In the incident of injection, the area should be washed with soap and water and if possible, Health Center should be called from 7666. Cautious use of any sharp object is always important. For supplying protection from the injection, cannulas should be substituted for syringes and gloves should be worn. 

Spills of Biological Material

The consequences of any spill of biological material can be minimized by performing all work on plastic-backed absorbent liners to absorb spills

A well-designed spill kit is highly recommended. It can save injury, time, and resources. For a Biohazard Spill Kit, the following items are highly necessary:

• A chemical decontaminant; generally a 10% household bleach solution is appropriate, the following fact should be kept in mind: Bleach will corrode stainless steel if left in contact with it for 30 minutes or more. For human blood and body fluids, iodophors or 70% alcohol is appropriate.
• Absorbant materials for liquids after decontamination; paper towels, absorbent lab pads, or special materials designed to absorb large volumes of liquid are appropriate.
• Appropriate personal protective equipment; gloves and a long-sleeved laboratory coat or gown, as well as facial protection are necessary during the clean-up procedure. Additional personal protective equipment is necessary when working with Class 3 agents.
• A mechanical means for handling broken glass; tongs, forceps, small disposable scoops and sponges, autoclavable dustpans, or any other method that prevents direct contact with the broken glass are necessary.
• Biohazard bags, autoclavable bags sharps containers, and/or other containers to place the material in for further treatment and disposal.

Biosafety level 1 organism spill 

Risk Group 1 infectious agents are biological agents that are unlikely to cause disease in healthy workers or animals (low individual and community risk).

• Wear disposable gloves.
• Soak paper towels in disinfectant and place them over the spill.
• Place towels in a plastic bag for disposal.
• Clean up spill area with fresh towels soaked in disinfectant.

Biosafety level 2 organism spill (moderate risk agents) 

Risk Group 2 infectious agents are pathogens that can cause human or animal disease but, under normal circumstances, are unlikely to be a serious hazard to laboratory users, the community, livestock, or the environment (moderate individual risk, limited community risk). Laboratory exposures rarely cause infection leading to serious disease; effective treatment and preventive measures are available and the risk of spread is limited.

• Alert people in the immediate area of the spill.
• Put on protective equipment. This may include a laboratory coat with long sleeves, a back-fastening gown or jumpsuit, disposable gloves, disposable shoe covers, safety goggles, mask or full-face shield.
• Cover the spill with paper towels or other absorbent materials.
• Carefully pour a freshly prepared 1 to 10 dilution of household bleach around the edges of the spill and then into the spill. Avoid splashing.
• Allow a 20-minute contact period.
• After the spill has been absorbed, clean up the spill area with fresh towels soaked in disinfectant.
• Place towels in a plastic bag and decontaminate in an autoclave.

Biosafety level 3 organism spill 

Risk Group 3 infectious agents are pathogens that usually cause serious human or animal disease, or which can result in serious economic consequences, but do not ordinarily spread by casual contact from one individual to another (high individual risk, low community risk), or that can be treated by antimicrobial or antiparasitic agents.

• Do not breathe; leave the room immediately and close the door.
• Notify others in the room to evacuate immediately, and assist others if necessary.
• Remove personal protective equipment in the airlock or access zone, turn potentially contaminated clothing outward, remove gloves last, and wash any exposed skin areas with antiseptic soap and warm water.
• Warn others not to enter the contaminated area. Place an appropriate sign on the door.
• Wait at least 30 minutes to allow dissipation of aerosols created by the spill.
• Put on a long-sleeved gown, gloves, appropriate respirator, and rubber boots, if required, before re-entering the room.
• Cover the spilled area with paper towels or disinfectant-soaked paper towels.
• Slowly pour the appropriate decontaminant solution around the spill and allow to flow into the spill. Avoid splashing or the creation of aerosols during this step.
• Let stand at least 15 - 20 minutes to allow adequate contact time.
• Using an autoclavable dust pan and squeegee, transfer all contaminated materials (paper towels, glass, liquid, gloves, etc.) into a deep autoclave pan, and autoclave promptly.
• Repeat the decontamination procedures.
• The dustpan and squeegee should be placed in an autoclave bag and autoclaved as well.
• Alert people in the immediate area of spill.
• Any employee exposed to human blood and body fluids must cleanse the affected areas as soon as possible:

Spill Involving human blood and body fluids

Skin contact/cuts/puncture wounds: wash with soap and water, then pour 3% hydrogen peroxide over the cut/lesion or wash with either chlorhexidine or iodophor.

Eyes: flush with water

Mouth: rinse well with 3% hydrogen peroxide and then water.

• Inform the LS or Responsible Faculty Member in case of exposure.
• A properly trained employee must proceed with the cleanup and decontamination of the spill area.
• Put on protective equipment (full face shield or mask and safety glasses/goggles, latex gloves, lab coat).
• Pick out any sharps using tongs or other mechanical means and cover spill-absorbent material such as paper towels.
• Carefully pour a freshly prepared 1/10 dilution of household bleach around the edges of the spill and then into the spill. Avoid splashing.
• Allow a 20-minute contact period.
• Use paper towels to wipe up the spill, working from the edges into the center.
• Clean spill area with fresh paper towels soaked in bleach solution.
• Place towels in a red bag for disposal.
• Remove protective equipment and wash hands thoroughly.

Spills within a biological safety cabinet 

• Leave the ventilation on.
• All items within the cabinet should be disinfected (Walls and surfaces wiped down, equipment wiped down and/or autoclaved).
• Cover the spill area with paper towels or absorbent material.
• Soak the spill area with an appropriate disinfectant (i.e. 10% bleach). Pour the disinfectant from the outside surface of the absorbent material towards the inside.
• Leave on for 20 to 30 minutes.
• Pick up with absorbent material.
• All waste should be autoclaved.
• Ventilation should run for 10-15 minutes.
• If the spill overflows onto the interior of the BSC contact LS or the technical service as a more extensive decontamination may be required.

Spills inside a centrifuge

• Leave lid closed and allow aerosols to settle for at least 1 hour (ensure centrifuge is off).
• Notify others in the lab not to use the centrifuge (include signage) and inform the lab supervisor.
• If possible move the centrifuge or at least the rotors and buckets to a BSC.
• Disinfect the centrifuge or rotors and buckets in an appropriate disinfectant, allow at least 20 to 30 minutes of contact time.
• Carefully retrieve any broken glass from inside the centrifuge using forceps and place in a sharps container.
• Drain the disinfectant.
• Thoroughly wipe down the inside of centrifuge and all parts including the lid with paper towels soaked in disinfectant.
• Rinse both the rotors and the inside of the centrifuge with water if bleach was used.
• All waste should be autoclaved.

Spills outside of a biological cabinet, in a laboratory

Biological spills outside biological safety cabinets will generate aerosols that can be dispersed in the air throughout the laboratory. These spills are very serious if they involve microorganisms that require Biosafety Level (BSL) 3 containment, since most of these agents have the potential for transmitting disease by infectious aerosols.

• Notify others.
• If an aerosol is generated (or the risk exists), hold your breath and quickly leave the lab. Close the door and post a warning sign. Evacuate the area for at least 30 minutes to allow aerosols to settle.
• Remove any contaminated clothing. For more hazardous substances place the contaminated clothing in an appropriate bag for autoclaving.
• Thoroughly wash exposed skin with soap and water.
• Assemble cleaning supplies and PPE.
• Cover the spill area with paper towels or absorbent material.
• Using an appropriate concentrated disinfectant cover the spill area. Pour disinfectant from the outside, towards the inside of the spill.
• Pick up any broken glass with forceps and place in a sharps container.
• Cover with absorbent material. For more hazardous substances, allow the disinfectant to act for 20 minutes.
• All adjacent areas should also be disinfected or wiped down.
• All waste should be autoclaved.

Spills outside the laboratory (during transport) 

If a biohazardous agent is spilled during transport outside the laboratory, the main difference from the first procedure is to initiate the clean-up immediately. Otherwise, use those procedures.

Because it would already be too late to prevent aerosolization in this case, it is better to place extra emphasis on prevention of spills during transport:

• Develop a procedure for the removal of biohazardous materials for incubation, refrigeration, or for any other reason from the laboratory, and enforce adherence to it.
• Place all such materials in an unbreakable container that would prevent the escape of liquid or aerosol if it were dropped. 2 – 4 liter paint pails are good examples of acceptable containers.
• Label the container with the biohazard symbol to ensure no mistake is made as to the contents
• Viable organisms should only leave the laboratory in a well-sealed primary (inner) and secondary (outer) container with a closable top. A test-tube rack inside a tray is not acceptable.
• The exterior of the secondary container should be wiped down with disinfectant prior to leaving the laboratory so that it can be transported without wearing gloves.
• Carry paper towels and if a spill occurs use the towels to cover the spill but do not attempt a clean-up without appropriate disinfectant and personal protective equipment.
• Notify people in the immediate area and collect clean-up material and proceed with clean-up.