Laboratory Safety Manual

Reviewed May 2012

Chapter 1: Emergency Response
Section 1.3 - Biohazard Spills

C. Cytotoxic/Antineoplastic Spills

1. General Procedures
   • Spills and breakages of cytotoxic/antineoplastic drugs (CDs) should be cleaned up immediately by a properly trained person using the appropriate procedures.
   • Broken glass should be carefully removed.

   • A spill should be identified with a warning sign so that other persons in the area will not be contaminated.

2. Personnel Contamination
   
   Overt contamination of gloves or gowns, or direct skin or eye contact should be treated as follows.
   • Immediately remove the gloves or gown.
   • Wash the affected skin area immediately with soap (not germicidal cleanser) and water. For eye exposure, immediately flood the affected eye with water or isotonic eyewash designated for the purpose for at least five minutes.

   • Obtain medical attention immediately.

3. Clean-up of Small Spills
   
   Spills of less than 5 ml or 5 gm outside a hood should be cleaned immediately by personnel wearing gowns, double surgical latex gloves, and eye protection.
   • Liquids should be wiped with absorbent gauze pads, solids should be wiped with wet absorbent gauze. The spill areas then should be cleaned (three times) using a detergent solution followed by clean water.
   • Any broken glass fragments should be placed in a small cardboard or plastic container and then into a CD disposal bag, along with the used absorbent pads and any non-cleanable contaminated items.

   • Reusable glassware or other contaminated items should be placed in a plastic bag and washed in a sink with detergent by a trained employee wearing double surgical latex gloves.

4. Clean-up of Large Spills
   
   For spills of amounts larger than 5 ml or 5 gm, the spread should be limited by gently covering with absorbent sheets of spill-control pads or pillows or, if a powder is involved, with damp cloths or towels. Be sure not to generate aerosols. Access to the spill areas should be restricted.
   • Protective apparel should be used with the addition of a respirator when there is any danger of airborne powder or an aerosol being generated. The dispersal of CD particles into surrounding air and the possibility of inhalation is a serious matter and should be treated as such.
   • Chemical inactivators, with the exception of sodium thiosulfate, which can be used safely to inactivate nitrogen mustard, may produce hazardous by-products and should not be applied to the spilled drug.

   • All contaminated surfaces should be thoroughly cleaned with detergent solution and then wiped with clean water. All contaminated absorbents and other materials should be disposed of in the CD disposal bag.

5. Spills in Hoods
   
   If the spill occurred in a glove box, clean bench or biological safety cabinet, the HEPA filter (contained in the cabinet) is more than likely contaminated. Label the unit "Do Not Use--Contaminated With (name of substance)." The HEPA filter and filter cabinet must be decontaminated and the filter changed and properly disposed of. This procedure may require the services of an outside contractor trained in the use of specialized personal protective equipment.

6. Spill Kits
   
   Spill kits, clearly labeled, should be kept in or near preparation and administrative areas. It is suggested that kits include a respirator**, chemical splash goggles, two pairs of gloves, two sheets (12x12) of absorbent material, 250 ml and one liter spill control pillows and a small scoop to collect glass fragments. Absorbents should be suitable for incineration. Finally, the kit should contain two large CD waste-disposal bags.
   
   (**The person who may use the respirator must be registered in the Respiratory Protection Program and have current fit test certification.)

7. Waste Disposal
   
   Disposal of all CD contaminated materials must be arranged through EHS.

            Emergency Response Leaking Compressed Gas Cylinders