Chapter 8: Biohazardous Spill Response

Even with the most careful planning and implementation of a research project, the possibility of an incident or spill involving biological materials exists. The following procedures are intended to provide a planned response to such rare events.

Preplanning for Biohazardous Spill Cleanup

All spills of biohazardous materials do not represent the same risk to personnel and the environment, making each spill somewhat unique. There are several factors that must be considered, including but not limited to: the pathogenicity of the agent, route of exposure, volume of a spill, the quantity, and other aspects such as sharps.

The following should also be considered when conducting an assessment:

• Location (e.g., biohazard cabinet, countertop, floor, equipment);
• Nature (e.g., tip-over, aerosolizing (spray/splash), drop from a height);
• Toxicity/infectivity of the spilled material;
• Volatility and viscosity of the spilled material;
• Other properties of material (e.g., pH, normality, temperature);
• Nature of affected surfaces (e.g., absorbent, porous or smooth-pitted); Additional challenges (e,g broken glass or sharps, clothing, mixing with other materials); and
• Susceptibility of spilled material to neutralization/disinfection

Preplanning of spill response will lower the risk associated with cleaning up a spill and will increase the likelihood that the spill is handled appropriately. Principal Investigators or Laboratory Directors should prepare their laboratory for typical spill scenarios expected in the laboratory. Laboratory workers should be informed of the hazards of the biological agents used in the laboratory, the risk associated with these agents during spill scenarios, how to safely clean up the agents, and how to properly dispose of cleanup materials.

Spill Cleanup Materials

Each laboratory area should have spill cleanup materials available to respond to the largest spill anticipated for that area. At a minimum, the following spill cleanup materials should be available in the laboratory:

• Disposable gloves (thick, chemical-resistant gloves or double pair of thin, nitrile gloves are recommended);
• Safety goggles and masks or a full-face shield (strongly recommended to avoid splashes to the nose and mouth);
• Lab coat or smock to protect clothing and body;
• Absorbent pads;
• Disinfectant appropriate for the agents used in the laboratory;
• Forceps or other devices to pick up contaminated material (especially sharps);
• Sharps disposal container;
• Autoclavable biohazard bags; and
• Respirators as required

The spill kits distributed by EHS to laboratories may not be adequate for the response to a biological spill. Additional items needed for the cleanup of biohazardous agents can be maintained in the laboratory.

Biohazardous Spill Cleanup Risk Assessment

Several factors must be considered when assessing the risk that a spill represents:

• Volume and concentration of the spilled material;
• The infectivity of the spilled material and routes of exposure;
• Location of the spill;
• Aerosolization potential of the agent resulting from the spill;
• Susceptibility of the spilled material to disinfection;
• Nature of the affected surface(s) and its ability to “hide” organisms from disinfection; and
• Immune status of immediate personnel

As with any spill scenario (biological, chemical, or radiological), the safety of personnel is the most important consideration. Cleanup is to begin only after it is determined that the personnel who will clean up the spill have appropriate knowledge, training, and equipment.

Biological Material Spill Cleanup Procedures

The following are general biohazardous spill cleanup procedures that are appropriate for most spill scenarios; however, the appropriate response to any spill is based on an assessment of the risk associated with that particular situation.

If in doubt, immediately call the Medical Campus Control Center at (617) 358-4144, for the CRC EHS emergency telephone at (617) 353-2105. Both response lines are active 24/7/365.

Biohazardous Spills Inside Biological Safety Cabinets

If a biohazardous spill occurs inside a Biological Safety cabinet, the following procedures should be followed:

• Wear a laboratory coat (disposable is recommended when available), safety glasses, and gloves (appropriate for the biological agent and the chemical disinfectant) during cleanup.
• Allow the BSC to run continually during cleanup.
• Surround the affected spill area with absorbent material to prevent spread of the spill.
• Apply disinfectant appropriate for the biological agent and allow a minimum of 20 minutes of contact time (or as directed by manufacturer’s instructions). Alcohol or other flammable liquids are not recommended.
• Wipe up the spill with paper towels soaked with disinfectant.
• Wipe the BSC’s walls and work surface, as well as any equipment in the cabinet, with disinfectant-soaked paper towel.
• Place contaminated items in an appropriate container (biohazard waste bag, sharps container, or autoclavable pan with lid for reusable items) for autoclaving or disposal in biohazardous waste box.
• Allow items to have a minimum of 20 minutes of contact time with the disinfectant (or as directed by manufacturer’s instructions) before removing them from the BSC.
• Remove disposable protective clothing and gloves, and place in a biohazard waste bag.
• Thoroughly wash hands and forearms with soap and water.
• Allow BSC to run for a minimum of 10 minutes before resuming work in the cabinet or shutting off the cabinet.

Biohazardous Spills in the Laboratory, Outside the Biological Safety Cabinet

If a BSL1 agent or less than 100 ml of a BSL2 agent is spilled, the following procedures should be followed:

• Remove any contaminated disposable protective clothing and place in a biohazard waste bag. Wash the hands and other areas affected by skin contact with soap and water.
• Wear a long-sleeved gown or lab coat (disposable is recommended), shoe covers, safety glasses (face shield also recommended), and gloves (appropriate for biological agent and disinfectant).
• Place absorbent pads over the spill (to absorb liquid), then place a second layer of disinfectant-soaked absorbent pads over the spill.
• Pour additional disinfectant around the spill, being careful to minimize any splatter or aerosolization, and work from the periphery toward the center, ensuring thorough contact between the spill and the disinfectant. Disinfect all items in the spill area.
• Allow a minimum of 20 minutes contact time (or as directed by manufacturer’s directions) with the disinfectant.
• Wipe down all equipment, tools, etc., with disinfectant.
• Place contaminated items in an appropriate container (biohazard waste bag, sharps container, or autoclavable pan with lid for reusable items) for disposal as biohazardous waste or for autoclaving as necessary.
• Remove disposable protective clothing and place in a biohazard waste bag.
• Thoroughly wash hands, forearms, and face with soap and water. It is recommended that cleanup personnel shower as soon as possible.

If the spill involves a BSL3/4 agent, or greater than 100 ml of a BSL2 agent, immediately evacuate all personnel from the affected area. Wait for aerosol to settle (usually a minimum of 30 minutes) before entering the spill area. Exception: If the laboratory is not under negative pressure, cleanup should begin as soon as possible to minimize the spread of aerosols.

In addition, the following procedures should be followed:

• Contact the BUMC Control Center at 4-4444 and notify EHS immediately for assistance with the cleanup.
• Remove any contaminated clothing and place in a biohazard waste bag for disposal or autoclaving as necessary and wash all areas affected by skin contact with soap and water.
• Wear a long-sleeved gown or lab coat (disposable recommended), shoe covers, safety glasses (face shield also recommended), and gloves (appropriate for biological agent and disinfectant). For cleanup of a BSL3 agent, a HEPA-filtered respirator may be required and for BSL4 agents, a full body pressurized suit.
• Place absorbent pads over the spill (to absorb liquid), then place a second layer of disinfectant-soaked absorbent pads over the spill.
• Pour additional disinfectant around the spill, being careful to minimize aerosolization, and work from the periphery toward the center, ensuring thorough contact between the spill and the disinfectant. Disinfect all items in the spill area.
• Allow a minimum of 20 minutes contact time (or as directed by manufacturer’s directions) with the disinfectant.
• Wipe down all equipment, tools, etc., with disinfectant.
• Place contaminated items in an appropriate container (biohazard waste bag, sharps container, or autoclavable pan with lid for reusable items) for disposal as biohazardous waste or for autoclaving and necessary.
• Remove protective clothing and place in a biohazard waste bag for autoclaving.
• Thoroughly wash hands, forearms, and face with soap and water. It is recommended that cleanup personnel shower as soon as possible.

Biohazardous Spills Inside a Centrifuge

If a biohazardous spill occurs inside a centrifuge, the following procedures should be followed:

• Clear the area of all personnel and allow aerosol to settle (usually a minimum of 30 minutes) before re-entering the area.
• Wear a laboratory coat (disposable recommended), safety glasses, and gloves during cleanup. For a BSL3 agent, a HEPA-filtered respirator may be required and for BSL4 agents, a full body pressurized suit is required.
• Transfer and open the centrifuge rotor and buckets in a BSC for cleanup.
• Using an appropriate disinfectant, thoroughly disinfect the inside of the centrifuge, the rotor, and buckets.
• Discard cleanup materials and protective clothing as biohazardous waste.
• Thoroughly wash hands, forearms, and other parts of the body with soap and water.

Biohazardous Spills Outside the Laboratory During Transport

When transporting biological materials between laboratories in the same campus, the samples must be contained in an unbreakable, leak-proof, primary container. The primary container must be placed inside a secondary container with absorbent material that is well-sealed and leak-proof container (see Chapter 11 for transportation guidelines). Both the primary and secondary containers must be labeled with the universal biohazard symbol with the identity of the agent. In the event a transport container drops and its contents are spilled, the following procedures should be followed:

• If necessary, clear the area of all personnel and secure the area.
• Cleanup should be initiated as soon as possible to prevent the release of potentially infectious aerosol. Attempt cleanup only if appropriate cleanup materials and protective clothing are available.
• Notify the Medical Campus Control Center at 617-358-4144 or the CRC EHS emergency telephone at 617-414-4075. Both response lines are active 24/7/365.

Note: Employees should become familiar with other non-spill emergencies, such as fire and medical emergencies. EHS has developed special emergency flip charts that are located in every lab and provide quick references to employees. Employees should review the charts so that in the event of an emergency, they are familiar with their location and content.

Site-Specific Spill Procedures

BSL3 and BSL4 facilities have site-specific emergency response and spill response procedures that are part of the facility Plans, SOPs and ERPs.

Spill Response

When responding to a spill, the following rules should be followed:

Tend to the injured

Ensure receipt of immediate medical care and do not attempt to move the injured individual(s) unless ambient conditions become life-threatening. Individuals splashed, sprayed with, or otherwise exposed to human blood or other body fluids or tissues during a spill will need to remove contaminated clothing and utilize basic first aid, washing any wounds immediately.

Await assistance

Unless laboratory personnel are trained and properly supplied and equipped with appropriate personal protective equipment, DO NOT attempt to clean up the spill. Personnel should immediately call the Medical Campus Control Center at 617-358-4144 or the CRC EHS emergency telephone number, 617-414-4075. Both response lines are active 24/7/365.

Isolate the spill

Evacuate the immediate spill area or the entire room in the case of an aerosolizing (splashing or spraying) spill or a spill of volatile material. Prevent others from entering the spill area with barricades or, if necessary, a sentry.

Contain the spill

Place absorbent material around, on, or in the flow path of the spilled material only if it can be done safely.

Provide information

Provide the information requested by the Control Center or EHS personnel and wait for the arrival of the emergency provider.

Clean up

Clean up should take place ONLY if laboratory personnel are trained, properly supplied with personal protective equipment, and otherwise able to clean up and disinfect the spill safely.
Chapter 9: Biohazardous and Medical Waste Disposal