Let us begin with a story: “Angela,” a histotechnologist, was filling a container with formaldehyde for the operating room. Upon opening the spigot of the five-gallon reagent cube, the cap snapped off, and formaldehyde poured down the front of her lab coat and pants. She was soaked with the chemical, and she knew she needed to rinse it off quickly before it began to irritate her skin.

She called to her laboratory co-workers for help and then she activated the lab’s safety shower. After approximately 45 seconds, one of Angela’s co-workers noticed the water was not going down the floor drain and was seeping rapidly toward a bank of computers set on the floor under a work bench. To avoid damaging the computers, she asked Angela to turn off the shower.

A hazardous material spill alert was called on the hospital loudspeaker system and when the facilities department staff arrived on the scene, they were not sure how exactly to respond, since they were unfamiliar with the chemical. When members of the lab staff finally cleaned up the spilled formaldehyde, they placed the absorbent materials into biohazard waste receptacles so the environmental services department could take it away.

The safety issues described in this scenario are numerous, albeit fictional; yet this is not an unheard of situation and some of these safety issues have the potential for great harm to laboratory employees, as well as others—ie, facilities and housekeeping staff—who work in support of the lab and the overall institution. Large hazardous materials spills are indeed uncommon in the laboratory setting, but when they do occur, it is vital that all related staff know how to respond using proper first aid and the correct spill response products and processes, as well as how to follow with proper storage and disposal of the waste according to regulations.

Chemical Spill Preparedness

The types of chemicals used and stored in clinical and anatomic laboratories can vary greatly, so it is vital that the correct spill management supplies are maintained according to a specific lab’s operations in the event of an accidental release situation. Chemical spill kits should be placed where their related chemicals are stored and handled, and this may result in multiple kits being placed throughout the departments. Furthermore, spill kits should not be placed directly in front of or below the stored chemicals, as staff must be able to access the spill supplies quickly and easily without impeding access to the chemicals themselves. Spill kits also should be identified using obvious signage so there is no guessing as to where appropriate remediation tools are stored.

Spill clean-up materials should include an appropriate universal absorbent designed for use with most chemicals. Other specialized absorbents may be needed as well based on a specific lab’s chemical inventory. Likewise, a chemical-specific neutralizer product should be readily available for areas that use and store formaldehyde. This carcinogen emits a dangerous vapor, and a neutralizer should be applied to it as soon as possible after a spill to limit off gassing. If acids and bases are utilized, acid and base neutralizing powders and absorbents also should be kept on hand.

Functional Use Dates and Additional Tools

Most chemical spill powders, neutralizers, and absorbents are not given an expiration date by the manufacturer. However, the College of American Pathologists (CAP) requires that such spill kits should be assessed periodically for proper usability and effectiveness. This does not mean that the powders need to be tested, but a visual check should be made of the container or product package. Look for container cracks or other damage, leaks, or evidence of clumps or wetness in the container. These checks should occur at least annually and should be documented. CAP also requires that spill products without an expiration date are labeled with the date they are put into service. While there is no written requirement for when to dispose of unused spill powders, it is generally advisable not to keep spill powders and absorbents more than five years before replacing them with fresh supplies. To prolong their best-use time frame, store supplies in a cool, dry place that limits environmental damage that can inhibit product effectiveness.

Other important spill supplies include absorbent pads and large-volume spill kits with booms to help absorb bigger spills and prevent spreading. These absorbent materials also can be helpful when the eyewash station or emergency shower is used. Using an eyewash or shower for the recommended fifteen minutes after an exposure will usually leave water on the floor, which requires consideration in the clean-up process. A safety shower can generate 20 gallons of water per minute, so the laboratory must be prepared to deal with at least 300 gallons of water pouring onto the floor if chemicals are spilled on a staff member. Naturally, that water will flow to the lowest point of the floor and may quickly overwhelm a standard floor drain (see SIDEBAR 1). Stocking large spill booms as part of the lab spill kit may be particularly important if other spill control barriers are not already in place proximate to the shower (see SIDEBAR 2). A shop-vac style vacuum also may be helpful in these situations.

The CAP standards require that the laboratory posts instructions for the emergency treatment of chemical splashes and injuries, as well as explicit directions for the control of chemical spills. These instructions should be located wherever major chemical hazards exist in the laboratory, such as in the anatomic pathology department or where chemistry analyzer reagents are kept. Clearly posting these instructions at eyewash stations and emergency showers in the lab also is a good idea.

In addition to stocking proper spill and safety supplies, make sure all staff members are adequately trained to use these supplies and other emergency equipment. Conduct drills to ensure competency in first aid response and proper chemical or water release event clean up. Although spills are not common, they do happen, and these regular practice drills will ensure fewer injuries, exposures, and less property damage.

Proper Chemical Disposal

When chemicals are spilled, the laboratory is suddenly in possession of hazardous waste that must be temporarily stored and disposed of properly. The spilled chemical, the absorbent powder used, and any other absorbent pads or mats all must be considered hazardous waste. Most important, these waste materials should not be placed into regular trash containers or containers for regulated medical (biohazard) waste. Only a licensed hazardous waste professional should remove these materials from the building. Typically, this is the same vendor that removes other chemical wastes from the department.

Spill clean-up waste can be placed into a bag labeled and intended for the storage of hazardous materials. If the chemical that was spilled is volatile and still emitting vapors, place the bag in a well-ventilated area or under a chemical fume hood. Label the bag with the words “Hazardous Waste – (chemical name) spill clean up.” Ideally, in order to comply with regulations from the US Environmental Protection Agency (EPA), the waste should be kept in a Satellite Accumulation Area (SAA) that is within the line of sight from where the spill occurred. If the waste vendor is not due to pick up other lab chemical waste soon, notify them to have the spill waste picked up as soon as possible.

The Lab Safety Dream Team

Independent and smaller labs may need to be prepared to handle large chemical spills by themselves, or they may need to connect with a vendor or even the local fire department to ensure adequate HAZMAT response if the need arises. In a hospital setting, the laboratory hazardous response should include collaboration with other facility department personnel. When a large chemical release occurs, one of the first steps in the response process should be to alert others in the facility and request a response from those able to assist.

The laboratory staff naturally should be the subject matter experts regarding the chemicals they use, and they should be trained to be the main spill response personnel. However, other facility team members can offer valuable assistance, especially if staffing in the lab is limited at the time of the spill event. Security staff can assist by helping to block off the area where the release occurred and provide first aid. They also can determine which outside staff can enter the area to provide assistance, while keeping others away to avoid exposure. Facilities personnel may be responsible for bringing extra spill supplies or a shop vac for cleaning up larger fluid volumes. They also can increase the room air exchanges if needed, such as when a volatile chemical is spilled in large quantities. That increased airflow will help in reducing the presence of harmful vapors.

When spill powders and absorbents are used and accumulated, the laboratory floor can become tacky or slippery. Thus, it is a good plan to have the environmental services department respond to a large spill so the floors (and any other affected surface) may be attended to after initial clean up. Given that environmental services department employees may not be experts on lab chemicals, they should not be made responsible for the immediate spill clean up; these are tasks that should be the responsibility of laboratory staff.

The main reason to call for help from other departments when a chemical release incident occurs is to elicit the best possible response decisions. When more situational experts with different perspectives arrive to assess the incident, team decisions can be made to determine the best remediation approach. It may be that the amount of chemical wastes generated is so large that only an outside HAZMAT team can safely manage the situation with the correct equipment. Utilizing facility resources to enable those decisions should be a part of the laboratory’s large-spill response exercises.

If other ancillary departments are part of your facility spill response program, make sure they clearly understand their roles dealing with a lab spill before an event occurs. Provide training and drill on procedures so there are no misunderstandings during an actual event. When running spill drills, make sure ancillary personnel are informed and involved.

Spill Risk Prevention

Accidents happen, and chemical spills can create substantial risk of harm to personnel and property. The safe storage and handling of laboratory chemicals goes a long way toward preventing such accidents. As an example, never store chemicals on a shelf in alphabetical order, as this increases the risk of placing incompatible chemicals next to each other. Ensure acids and bases are separated as well. While no one expects new containers to be damaged, defects and leaks can occur, and the lab should avoid any mixing of chemicals that could create a dangerous reaction (see FIGURE 1).

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Furthermore, do not store chemicals on high shelves to reduce the chance of dropped containers or spilling chemicals onto the face of the user. Acids and bases should be stored near the floor (separately), and larger amounts should be placed inside corrosive storage cabinets. Use bottle carriers when transporting large volumes of chemicals in glass containers and ensure chemical containers are closed completely when not in use.

Laboratory generated hazardous (chemical) waste should be stored properly as well. As previously mentioned, the EPA requires that waste should be stored in a temporary storage area—the SAA—which must be in a line of sight from where the waste was generated. If it is flammable waste, store it inside of a flammable storage cabinet also in a line of sight.

Up to 55 gallons of hazardous waste can be stored in a SAA and waste cannot be moved from one SAA to another. However, waste may be moved from an SAA to the facility’s Central Accumulation Area (CAA) for pick up and disposal by the waste vendor. Some vendors also will pick up directly from the SAA(s). Make sure waste containers are closed properly to prevent leaks. Secondary containment (such as modular platforms or shelving with rims that prevent spillover) in waste storage areas can help contain an accidental release and the EPA requires such containment in a CAA.

Conclusion

The safety issues described in the opening story should have been avoided. The spigot on the chemical container should have been checked. The laboratory should have been prepared for the amount of water that the safety shower provided, and they should have been trained to be ready for it. The spill responders should have known how to properly dispose of the spill clean up materials.

Fortunately, hazardous material releases in the laboratory are low-frequency occurrences, but the risks they pose are substantial. Make sure your laboratory is prepared. Ensure the proper storage and handling of laboratory chemicals, and check to see that departmental spill supplies are available, adequate, and up to date (see FIGURE 2). A swift and proper response to an accidental release of hazardous materials in the lab is possible. With preparation and training, both property and lives can be saved when such a situation arises.

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Daniel J. Scungio, MT(ASCP)SLS, CQA(ASQ), has over 25 years’ experience as a certified medical technologist. He worked as a laboratory generalist in hospitals ranging from 75 to 800 beds before becoming a laboratory manager, a position in which he served for 10 years. Dan is now the laboratory safety officer for Sentara Healthcare, a system of more than seven hospitals and over 20 laboratories and draw sites in the Tidewater area of Virginia. As “Dan the Lab Safety Man,” he also serves as a professional speaker, trainer, and lab safety consultant. Dan received his BS in medical technology from the State University of New York at Buffalo.

SIDEBAR 1

Safety Showers and Drains

Some laboratory safety showers are installed with a floor drain in place and others are not. Laboratory staff can be mystified that a piece of equipment that produces so much water would be placed in an area where no drain exists, but often, that is by design. When the need arises for the use of an emergency shower, it is often because someone has become contaminated with a substantial amount of a hazardous chemical. Most locales forbid dumping hazardous or toxic wastes down the drain, even in an emergency. To accommodate this, some laboratory showers have their own dedicated drain and holding tank. Regardless of whether a drain is present, make sure the lab is prepared by having large-volume spill kits, large absorbent barriers, or other containment located near the shower area. Even with a drain in place, often there will be excess water on the floor if the shower is used properly.