Operational Handbooks

1. WHO handbook for guideline development. Geneva: World Health Organization, 2012.

2. Laboratory biosafety manual, 3rd edition. Geneva: World Health Organization, 2004 (WHO/CDS/CSR/LYO/2004.11). (Also available from http://www.who.int/csr/resources/publications/biosafety/en/Biosafety7.pdf.)

The laboratory manager is responsible for maintaining spill response kits. Two spill response kits should be prepared: one placed outside the containment laboratory and one placed inside the laboratory. The kits should include the items listed below.

Spill response kit:

Always use sealed centrifuge buckets, and load and unload them in a BSC. If breakage occurs during centrifuging, broken tubes must be discarded in a puncture-resistant container and disposed of immediately.

Decontaminate centrifuge buckets by soaking them in a suitable disinfectant. Do not use bleach to disinfect metal parts because it causes corrosion. Alternatively, buckets may be decontaminated by autoclaving.

When a spill of infectious material occurs within a BSC, a clean-up procedure should begin immediately, and the cabinet should continue to operate.

1. Place absorbent tissue over the spill area, and apply disinfectant solution liberally.

2. If the walls of the BSC have been splashed, clean with a layer of absorbent paper towel liberally soaked in disinfectant solution.

3. Leave affected areas covered with disinfectant for 30 minutes to 1 hour.

4. Carefully collect contaminated sharps material, and place in a puncture-resistant container for disposal.

A spill of infectious material outside a BSC is considered a major event. Spills of infectious liquid will generate infectious aerosols. Everyone should immediately vacate the affected laboratory area. The laboratory manager should be informed of the incident immediately, and staff must be prevented from re-entering the laboratory for at least 1 hour to allow aerosols to be removed through the laboratory’s ventilation system and allow time for heavier particles to settle.

The plan should provide operational procedures for:

A written emergency preparedness plan for dealing with laboratory incidents and accidents is a necessity in any facility that works with or stores M. tuberculosis isolates.

Laboratory staff should be trained to remove their gloves by following these steps:

1. peel one glove off by grasping it under the cuff and rolling the glove off the hand so that it comes off inside out. This keeps most of the contamination inside;

2. hold the used glove in the opposite still-gloved hand. Carefully slip exposed fingers under the cuff of the gloved hand, being careful not to touch the surface of the contaminated glove. Peel the glove off, inside out, rolling it over the other used glove to form a bag of used gloves with contamination inside.