Working with Sharps
Regulations Relating to Sharps Usage and Injury Prevention:
OSHA has promulgated a regulation on Bloodborne Pathogens (29 CFR 1910.1030) that contains sharps guidelines as well as the United States House of Representatives passed Public Law 106-430 that added to these regulations. The public law established that employers must create and maintain an exposure control plan that contains effective engineering and work practice controls for workers using sharps in everyday activities. Since Georgia Tech is a part of the State of Georgia government, the OSHA regulations do not have to be followed but Georgia state law is mandated. Thus, Georgia Tech must followed House Bill 1448 that essentially mimics Public Law 106-430. (http://www.legis.state.ga.us/legis/2003_04/gacode/31-12-13.html)
- Sharps — this term means any discarded article that may cause punctures or cuts and has been exposed to infectious or potentially infectious agents, including humans and mammals. This includes, but is not limited to, items such as needles, IV tubing and syringes with needles attached, and scalpel blades.
Georgia Tech´s Procedures for Handling Sharps:
- Contaminated Sharps (needles and syringes, Pasteur pipettes, etc.) must be placed in puncture proof and leak proof containers which are closed and transported to the autoclave for sterilization prior to disposal.
- Sharps should never be resheathed prior to disposal unless the sharp comes equipped with a safety device designed to be engaged after usage.
- Use sharps with safety devises whenever possible or use needleless systems to conduct research.
- All sharps containers should be labeled with the PI´s name and the date the box was placed in the work area. This is to ensure that sharps boxes remain in the originating laboratory and can be indentified during the disposal process if required.
- Sharps should be disposed of as biohazardous waste. The outer box must be labels to indicate that the box contains sharps to allow for proper disposal since most sharps are classified as medical waste.
Biological Spill Procedures
Primary responsibility for preventing and/or containing and cleaning up laboratory spills remains with the principal investigator or laboratory supervisor. Laboratory protocols should be carefully designed to prevent biological, chemical and/or radiation spills.
When accidents occur that involve the mishandling or escape of biohazardous materials, the principal investigator or laboratory supervisor is to be notified immediately. Spills of high risk organisms (certain Class 2 and all Class 3) should be reported to the Biosafety Officer at 404/894-6119 during normal working hours or to Georgia Tech Police at 404/894-2500 after normal working hours by the principal investigator or laboratory supervisor. All employees and/or students have an obligation to themselves and their colleagues to report accidents immediately in order to minimize potential hazards.
When a biohazardous spill also involves radioactivity, cleanup procedures may have to be modified. The extent of the modification will depend on the level of radiation and the nature of the isotope involved. The Radiation Safety Officer should be called during normal working hours at 404/894-3600, or Georgia Tech police should be called after working hours at 404/894-2500.
The following guidelines must be followed by the principal investigator, laboratory supervisor, and other responsible individuals who may be involved in the cleanup of biological spills.
Biohazard Spills inside Laminar Flow Biological Safety Cabinets (LFBSC)
The occurrence of a spill in the biological safety cabinet poses less of a problem than a spill in an open laboratory as long as the spilled materials are contained in the biological safety cabinet. Decontamination of the work zone can be effected by direct application of concentrated liquid disinfectants along with a thorough wipe down procedure. Gaseous decontamination may be required to clean-up the interior sections of the cabinet.
- Chemical decontamination procedure should be initiated immediately while the biological safety cabinet continues to operate. Continuing the operation of the LFBSC helps to prevent the escape of contaminants from the cabinet.
- Wearing protective gloves, safety glasses, a lab coat/apron, and at a minimum a surgical mask, spray or wipe walls, work surfaces, and equipment with an appropriate decontaminating solution. A disinfectant detergent, such as Wescodyne or Environ has the advantage of detergent action on extraneous organic substances which may interfere with the microbicidal activity of the disinfectant.
- Be sure to choose a disinfectant that takes the pathenogenic properties of the organism into account. Not all organisms are killed by ethanol and require a more powerful disinfectant.
- Flood tray top, drain pans and catch basins below work surface with decontaminating solution and allow to stand for 20 minutes.
- Drain excess decontaminating solution from tray and drain pans into cabinet base. Lift out tray and removable exhaust grille work. Clean the top and bottom (underside) surfaces using a sponge or clean cloth soaked in decontaminant solution. Following the cleaning process, replace the tray and grille work in their proper position. Place gloves and sponge or cloth in autoclave pan and autoclave these items.
- Drain decontaminating solution from cabinet base into appropriate container and autoclave according to standard procedures.
- If gaseous decontamination of the cabinet´s interior sections is needed, call the call the biosafety officer, Lee Zacarias, at 404-894-6119.
Biohazard Spills Outside Laminar Flow Biological Safety Cabinets (LFBSC)
The protocol to be used in cleaning up of spills involving microorganisms will depend on the amount of material spilled and the degree of laboratory containment required.
If individuals believe that their outer garments have been contaminated, they should remove their clothing in the laboratory area and place them in an autoclave or a container for autoclaving. They should change into clean clothing in a non-contaminated area. All laboratory personnel should keep a complete change of clothing, including shoes at the laboratory in case of spills.
Special care in decontamination will be necessary when a spill goes under or between fixed furniture or behind base moldings (floor/wall), or if floor penetrations are involved.
- Minor Spills (less than 10 ml and generating little aerosol) on equipment, laboratory benches, walls, or floors:
- Warn all personnel not essential for spill containment to stay clear of the contaminated area. This may be accomplished verbally or, when appropriate, by posting warning signs on the doors.
- Thoroughly wash hands and other apparently contaminated areas with soap and water. Put on clean disposable gloves.
- Cover the spill area with paper towels soaked in appropriate decontamination solution.
- Wipe up the spill with the soaked paper towels and place the used towels in an autoclave pan and autoclave.
- Pour decontaminating solution around and on the area of the spill. Let stand for 20 minutes then wipe up with paper towels. Place gloves and paper towels in autoclave pan and autoclave.
- Wash hands and other apparently contaminated areas again with soap and water.
- Major Spills (more than 10 ml or with considerable aerosol):
- Close laboratory doors and post warning signs to prevent others from entering the laboratory.
- Wash hands and other apparently contaminated areas with soap and water.
- If personal clothing is contaminated, remove all outer clothing and place it in autoclave or container for autoclaving. Put on clean garments.
- Report the accident to the supervisor and to the Biosafety Officer at 404/894-6119.
- Leave the laboratory for 20 minutes to allow dissipation of aerosols created by the spill.
- Upon returning to the laboratory to start decontamination, check to see if laboratory doors are closed and appropriate signs are displayed. Put on surgical gloves. Respirators or other safety equipment may be required, depending on the microorganism involved. Check with the Principal Investigator or Laboratory Supervisor or Biosafety Officer.
- Pour a decontamination solution around the spill and allow this solution to flow into the spill. Do not pour decontamination solution directly onto the spill in order to avoid additional release of aerosols.
- Let decontamination solution — microorganism mixture stand for 20 minutes or longer to allow adequate contact time.
- Spills kit absorbent material should be used to cover the area and soak up the disinfectant/organism mixture.
- Using autoclaved dust pan and squeegee transfer all contaminated materials to deep autoclave pan, cover with suitable cover, and autoclave according to standard directions.
- Place dust pan squeegee in an autoclavable bag and autoclave according to standard directions.
- Remove gloves and other contaminated safety clothing and place them in an autoclave container for autoclaving.
- Thoroughly wash hands, face, and other potentially contaminated areas.
Special care in decontamination may be necessary. The Principal Investigator and/or Biosafety Officer may require the collection of sample cultures to determine that the area has been effectively decontaminated.
Certification of Biological Safety Cabinets
Biological safety cabinets and other containment devices shall be maintained in good working condition by the Principal Investigator (PI). When a PI wishes to purchase a new BSC, EHS should be consulted to determine the proper class for the proposed research as well as to schedule a certification. All new BSC must be certified by the EHS contractor prior to usage. Certification of existing BSCs is to be accomplished annually, in the event that the BSC is moved, the HEPA filter is changed, major repair accomplished, or whenever the contaminated plenum is breeched. Any movement of a BSC can cause damage to the HEPA filter, gaskets, or other seal that protect workers. EHS provides all BSC on campus with free certifications. This is done to ensure that all BSCs are being certified on a regular basis as well as relieve PIs of the burden of having to find and pay a certifier each year. Contact Lee Zacarias at 404-894-6119 to schedule a certification. .
Working with Autoclaves
All researchers, students, and staff using campus autoclaves should be knowledgeable of proper usage and technical aspects of autoclaves. Several factors affect the steam sterilization process including load size, distribution and compaction, altitude above sea level; and heat penetration. The investigator or personnel responsible for sterilization may have to determine the appropriate time at standard autoclave temperature and pressure for certain loads of biohazardous materials. Barbeito and Gremillion in their article "Microbiological Safety Evaluation of an Industrial Refuse Incinerator" (Applied Microbiology 16:2:291-95) reported on various times required for autoclaving selected mammalian carcasses, mammalian bedding materials, and eggs. With some loads, even extended times did not provide for sterilization. Effective decontamination and sterilization by steam depends on the adequacy of circulation of the steam; loads packed tightly may not allow for adequate circulation. The steam must penetrate all packaging materials and contact all surfaces to be decontaminated or sterilized. And, finally the packaging must prevent the recontamination of the sterilized materials. To achieve effective and safe use of the autoclave the laboratory personnel must be familiar with and follow the laboratory´s procedures regarding:
- Types of packaging — autoclavable pan, bag in pan, double bag, etc.
- Separating into pans/bags for autoclaving in the lab
- Adding water/germicidal solutions — Do not autoclave radioisotopes or explosive or volatile chemicals without checking with radiation safety, laboratory safety and biological safety.
- Try to use specific autoclaves — "dirty" autoclaves for decontamination and "clean" autoclaves for sterilization and biological media.
- Proper settings for type of cycle, and type and amount of material. Details of proper operation and settings may be contained in the specific device operation manual. Monitor the autoclave process for proper cycle and length of time. Cycle and time depend on what is being sterilized. For example, liquids would require the use of slow exhaust and while most loads require cycle times of 15 to 30 minutes at 121°C, longer times may be needed to meet the thermodynamic needs of special loads. The decontamination of biomedical waste may regularly require 60 minutes at 121°C.
- When the cycle is completed care must be taken to wear proper personal protective equipment and to use proper unloading procedures. These include: personal protective equipment - laboratory coat and apron that resists liquid (i.e. rubber/plastic) gloves that are heat and liquid resistive, and goggles and/or face shield. Procedures - Stand away from the autoclave door when opening to avoid a rush of steam and open slowly; do not move boiling liquids; and allow sufficient cooling time before handling superheated solution (i.e. microbiological culture media) to avoid burns and exploding glass.
- Spill clean-up procedures should be posted in every autoclave room and followed when a spill occurs.
Each autoclave should have a form that requires the user to fill-in at least the date, time, phone, cycle, and signature. This will allow for better maintenance and flow of trash removal. A sample form can be found at:
All autoclaved biohazardous waste shall be packaged in a biohazard box and marked with the appropriate content information, PI, and date. No autoclaved biohazardous waste may be disposed of into a dumpster even if the bag is covered with a regular black trash bag. All autoclaved biohazardous waste must be picked up by EHS Hazardous Materials group.
Biological Waste Disposal
It is expected that investigators using biohazardous agents and/or producing biomedical wastes as defined below will comply with the rules promulgated by the Georgia Environmental Protection Division in Chapter 391-3-4 section .15 "Solid Waste Management" and Georgia Tech policy. The waste streams generated by biological laboratories should be separated into non-hazardous waste (trash), biohazardous waste, chemical waste, and radioactive waste.
Georgia Tech´s Procedures for handling biomedical wastes on campus
- Biomedical/biohazardous waste shall be segregated by separate containment from other waste at the point of generation. These wastes, except for sharps, are to be placed in orange or red plastic bags clearly identified with the universal biohazard symbol or clearly marked with the word "BIOHAZARD". The bags are to have strength sufficient to preclude ripping, tearing, or bursting under normal conditions of use. The bag must then be placed into a biohazard cardboard box and properly marked with the Principal Investigator´s name and laboratory number.
- Broken glass may or may not be considered biomedical waste — glassware that has been contaminated with biohazardous agents must be decontaminated (autoclaving or chemical disinfection) prior to disposal with broken glass.
- Contaminated mammalian carcasses should be collected in leak proof closed containers. Clearly mark the biohazardous waste box with the appropriate classification of "animal carcass".
- Human tissue can be disposed of two separate ways. If the human tissue is unrecognizable as an organ or body part, the tissue can be disposed of in a biohazardous waste bag and box. If the human tissue is an identifiable body part or organ, the PI must clearly mark on the box "human tissue". This segregates the waste for proper disposal by cremation or burial.
- No red biohazard bags or other bag marked with the biohazard symbol shall be disposed of in the dumpsters outside of buildings.
- Liquid biohazardous materials are to be properly inactivated or sterilized prior to disposal in the community sewage treatment system. Methods for inactivation may be specific to the biohazardous agent contaminating the liquid. See the biosafety manual´s guide to liquid disinfectants to select an appropriate chemical disinfectant or autoclave the material based on standard methods of 121 degrees for 30 minutes at 20 psi.
- Biomedical wastes may be treated so as to render items non-biomedical wastes. Biomedical wastes may be treated by autoclaving in a recording autoclave. Recording of the temperature during each complete cycle shall be used to assure the attainment of 121°C or 250°F for a minimum of 30 minutes in order to achieve decontamination of the entire load.
Contact the Biosafety Officer in Environmental Health & Safety at 404-894-6119 regarding questions about the proper handling of biohazardous waste.
Contact the Hazardous Materials Manager in Environmental Health & Safety at 404/894-6224 regarding contract arrangements for pick-up and disposal of biomedical wastes including sharps.
The Select Agent Program deals with infectious organisms and toxins that can be used to endanger human health and/or agricultural animal or plant health. The Center for Disease Control and Prevention (CDC) and the Animal and Plant Health Inspection Service (APHIS) of the USDA are charged with regulating these organisms. The agents list contains bacteria, viruses, fungi, rickettsias, and toxins. The list includes organisms regulated only by the CDC, those regulated by the USDA, and those jointly regulated by both groups. The Responsible Official for Georgia Tech will help any researcher in determining the proper procedures for acquiring, housing, transferring, and destroying any select agent. Approval must be obtained from the Responsible Official and the appropriate agency prior to acquisition of the select agent. Once the laboratory has the proper approvals, it becomes subject to inspections by the CDC and APHIS to determine if all of the regulations are being followed properly. The regulations require reporting, inspection and security in any laboratory that houses a select agent. The forms for registration and security guidelines can be found on the CDC website at http://www.cdc.gov/od/sap/ as well as on the APHIS website at http://www.aphis.usda.gov/programs/ag_selectagent/.
There are exceptions to the rules. The following toxins are exempt in limited quantities as long as an entire facility does not have more than exempt amount. These include:
|Botulinum neurotoxin||0.5 mg|
|Clostridium perferingens epsilon toxin||100 mg|
|Shiga-like ribosome inactivationg proteins||100 mg|
|Staphylococcal enterotoxin||5 mg|
Select Agent destruction requires notification to the Responsible Official via email at least a week in advance. This notification is required even for exempt toxic agents. EHS will attend the destruction and schedule a hazardous waste pick up of the material.
a. The method of destruction should be based upon the type of select agent. Bacteria and viruses can be autoclaved for 1 hour at 121 degrees. Staphylococcus Enterotoxin, Ricin, Botulinium Neurotoxin, Clostridium perfringens epsilon toxin, Shiga toxin and the Shiga-like ribosome inactivating proteins can be autoclaved for 1 hour at 121 degrees. Tetrodotoxin, Staphyloccocus Enterotoxin, Botulinum Neurotoxin, Ricin, Shiga toxin and the Shiga-like ribosome inactivating proteins can be inactivated by exposure to 2.5% sodium hypochlorite (NaOCl) with .25 N sodium hydroxide (NaOH) for at least thirty minutes.
b. Other select agents may require different methods. Contact EHS to determine the appropriate method.