Bloodborne Pathogens Guide, Appendix 6

Appendix 6

Rutgers University Procedures for Cleaning and Disinfecting Spills of Blood or Other Potentially Infectious Material

All work locations covered under the standard (those where empolyees may be reasonabley anticipated to come into contact with blood or other potentially infectious material) must have equipment available to safely and effectively clean-up spills of blood or other potentially infectious material. This equipment must include, at a minimum:

Personal Protective Equipment (PPE)

Disposable Gloves

Protective Eyeware

Disposable Face Mask

Disposable Gown or Apron

Antiseptic Towelettes

Spill Clean-Up Equipment

Disposable Absorbent Material (e.g., Paper Towels or Lab Table Soakers)

Red Medical Waste Bag for Disposal

Appropriate Germicidal Solution

Forceps or Other Mechanical Means for Picking-Up Broken Glass

		Spill Kits may be assembled by eligible employees in various work locations. Alternatively, a variety of spill kits are currently available commercially. The pre-packaged spill kits are particularly well suited for use in police, fire, and other emergency service vehicles. Two examples of commercially available spill kits are the Clothing and Biosafety Spill Kit (item #23828 Lab Safety Supply Catalog) and the Vital 1 Emergency Response Pack (item #17-206-6 Fisher Scientific Catalog). Regardless of the type of spill kit used, the steps, described below, should be taken when cleaning and decontaminating spills of blood or other potentially infectious materials:

Cleaning and Decontaminating Spills of Blood or Other Potentially Infectious Body Fluids

Put on appropriatepersonal protective equipment (PPE) including double gloves, gown, protective eyeware, and face mask.

Control access to area. Prevent people from walking through affected area and thereby tracking the blood or other potentially infectious material to other areas.

Contain spill. Use paper towels or other absorbent material to contain spill.

Use forceps, plastic scoop, or other mechancial means to remove any broken glass or other sharp objects from the spill area. Take care not to create aerosols. Place these items into a small cardboard box, thick walled plastic bag, or other container that will prevent them from puncturing the red bag (or your hand). Place the contained sharp items into the red bag for disposal. Do not seal bag.

Apply appropriate disinfectant. To avoid creating aerosols, never spray disinfectant directly into spilled material. Instead, gently pour disinfectant on top of paper towels covering the spill or gently flood affected area first around the perimeter of the spill, then work disinfectant slowly into spilled material.

Allow several minutes of contact time with disinfectant.

Pick-up all absorbent material and place carefully in red bag for disposal. Do not seal red bag.

Clean affected area again with disinfectant and new paper towels. Place used paper towels in red bag for disposal. Do not seal red bag.

Dry area. Place used paper towels in red bag for disposal. Do not seal red bag.

many commercially available spill kits are equipped with a powder that solidifies the spill and a small plastic scoop used to pick-up the solidified spill. If you are using such a kit follow the directions that come with the kit. Avoid creating aerosols when cleaning blood spills regardless of the type of spill kit used.

Once spill is completely cleaned, place all used spill control equipment in the red bag for disposal. Do not seal red bag.

Remove PPE and place in red bag for disposal. Remove PPE in the following order:

Remove soiled gown.

Remove outer pair of disposable gloves.

Remove face mask and protective eyeware.

Do not remove PPE from face with soiled gloves. Remove soiled outer gloves first and place them in the red bag for disposal. Use clean inner glove to remove PPE from face. This prevents the introduction of blood or other potentially infectious material to the mucous membranes of the face via a contaminated glove.

Once all used PPE, spill control equipment, and other potentially contaminated items are in the red bag seal bag securely for disposal. See Appendix 5 for information concerning the proper disposal of regulated medical waste at Rutgers University.

Wash hands.

Cleaning and Decontaminating Laboratory Spills of Potentially Infectious Microorganisms

		Many laboratories are involved in the culture, growth, and manipulation of potentially infectious microorganisms. When spilled, concentrated cultures of potentially infectious microorganisms present a risk of disease transmission to laboratory workers. All laboratories (research, diagnostic, or other) working with potential pathogens must have a written plan for dealing with spills or other releases of such materials.

		Spill kits specifically designed for the clean-up and decontamination of biological spills in laboratories are commercially available and amay be obtained through the Lab Safety Supply Catalog and other similar publications. Spills in the laboratory may be divided into two categories: those occurring within the biosafety cabinet and those occurring outside the biosafety cabinet.

Spills Occurring Within the Biosafety Cabinet

		When an infectious material is spilled within the biosafety cabinet it should be cleaned-up immediately by the individual performing the work. If the cabinet is certified and working properly (and not overfilled with lab equipment which limits the cabinet's air flow) there is little risk of aerosolization of the material into the general laboratory environment.

		When cleaning and decontaminating a spill within a biosafety cabinet care should be taken not to move hands and arms into and out of the cabinet unnecessarily. This action creates turbulence that reduces the laminar air flow characteristics and effectiveness of the biosafety cabinet. A suitable disinfectant and laboratory wipes should always be available within the cabinet or on the supply cart or table directly adjacent to the biosafety cabinet. Additionally, employees working with potentially infectious microorganisms must wear adequate personal protective equipment (PPE).

		To effectively clean and decontaminate a spill within the biosafety cabinet:

With cabinet running, cover affected area immediately with lab wipes or other available absorbent material.

Using a prepared spray bottle of a disinfectant appropriate for the material being worked with, gently spray disinfectant on top of covered spill.

Allow sufficient contact time.

Pick-up absorbent material and place in small autoclave bag inside biosafety cabinet. Do not seal bag.

Clean affected area again with disinfectant. If chlorine bleach is used, the affected area should be cleaned one final time with 70% Ethanol. the chlorine bleach will pit and corrode the stainless steel work area inside the biosafety cabinet.

Place sealed bag in biohazardous waste receptacle.

Spills Occurring Outside the Biosafety Cabinet

		Spills of infectious agents, especially those requiring biosafety level 2 containment or higher, outside the biosafety cabinet present a considerable risk of infection to laboratory workers. The laboratory in which the spill occurs should be vacated immediately by all occupants. Any laboratory worker requiring medical attention should be escorted to University Health Services for medical evaluation and treatment. The laboratory supervisor should report the spill to REHS as soon as possible.

		The laboratory should remain vacant for at least 30 minutes. This allows aerosolized droplets to settle and the building's ventilation system to exhaust droplets which are airborne to the external environment. In some instances (e.g., buildings with recirculating ventilation systems) the ventilation system servicing the affected portion of the building may need to be shut down to prevent the dissemination of contamination.

		In general, the steps taken to clean and decontaminate spills of an infectious agent outside the biological safety cabinet are identical to those taken when cleaning spills of blood and other potentially infectious material. Additional precautions may need to be taken depending on the particular properties of the spilled agent as well as the volume of the spill. A more thorough discussion of the cleaning and decontamination of spills of infectious material in laboratories may be found in the biosafety section of the Rutgers University Health and Safety Manual.

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Last Updated:01/10/06