Cleaning Up Medical Waste Spills


Here we cover (1) short-term reaction to spills of waste, (2) clean-up process, and (3) recording spill incidents. You should have an emergency plan for big disasters.

When a spill occurs

  • Have non-essential personnel leave/stay away from spill
  • Wash eye and skin of anyone exposed
  • Figure out what has spilled - the type and amount of waste
  • Take measures to stop further spread of waste
  • Have designated clean-up personnel come to site
  • Get spill kit/clean-up supplies
  • Provide PPE for clean-up personnel if needed
  • Neutralize acid or alkaline spills. Absorb liquid to solid or semi-solid material
  • Pick up / sweep spilled waste to plastic bags or other containers for transport to storage and ultimately treatment
  • Rinse or mop area and dry
  • Inspect for residual waste before opening area for normal operations

Cleaning Up Medical Waste Spills

Most spills or accidental small releases of medical waste can be handled by facility personnel using PPE. Radioactive waste is special, if not always more hazardous, and only specially trained workers should handle it. OSHA has special regulations for handling of regulated bloodborne waste; these involve certain PPE and procedures.

Consider employing a double-bagging process as part of your standard procedure for cleaing spills.

Wet vs dry

Dry spills are generally less risky and worrisome than wet spills. Dry materials can more easily be contained and swept up into storage bags or barrels. Friable materials - easily crumbled - are more of a headache because pieces might break off while you are trying to clean up.

The technician on the ground needs to make a choice about whether to use PPE in cleaning up dry waste. At a minimum gloves and eye protection is advisable. A facemask may also be called for. Once the waste is in a plastic bag, it should be labeled immediately. We stress that because we have seen many times when people forget to do that and are stuck with a waste bag they cannot be sure about. And if there’s anything you want to be sure about in waste management, it’s where your waste came from.

Wet spills include those with free running liquids (which can spread out and seep into the ground or building concrete) and semi-liquid materials. A wet sponge is a good example of a semi-liquid material. It can release liquid, especially under stress. Liquids are tough because they carry potential hazards (including pathogens) away from the source waste. They spread out the bad stuff. And because they offer the potential for aerosolization. That is, tiny particles of liquid can become airborne (an aerosol). This poses a great hazard. Aerosols can enter the respiratory systems of people and spread disease. They can be blown on the wind long distances.

How do you stop a liquid from spreading and from becoming an aerosol? Soak it up in an absorbent solid. Even paper towels are useful. Many companies make pellet absorbers for industrial hygiene applications. They are often used in warehouses for keeping grease from accumulating on the floor. Check the specifications on the pellets. Some may be designed for grease and oil spills and others for water-based spills. Infectious waste is more likely (though not always) to be aqueous, so keep absorbents that take up water on hand. Custom-made mercury spill kits include a suppressant intended to prevent vaporization of that liquid metal.

What do you do with the absorbents (or paper towels) once they have done their job and taken up the water? Seal them in a plastic bag for disposal. These materials can be incinerated.

Buying a spill cleanup kit versus making your own.

You can buy a kit, but they are not difficult to make. Include screw-top containers, sealable plastic bags, small brooms and dustpans, gloves, and goggles. These should be enough for most spills.

Simple kit

  • 2 pairs gloves
  • 2 pairs safety glasses
  • 4 screw cap containers
  • 5 plastic bags (capacity 1 pint)
  • Brush
  • Dust pan
  • Paper towels
  • Non-chlorine containing liquid cleaner in spray bottle and similar clean-up aids

Bigger kits

Add

  • Pads
  • Socks
  • Broom
  • More plastic bags, gloves
  • Mop and bucket
  • Powdered detergent

More specialization

Add

  • Vacuum
  • Mercury Aspirator - a syringe to a dedicated vacuum for mercury and used to remove mercury from surfaces

Accident Logs

We categorize accidents as

  • Trivial
  • Moderate
  • Serious

Keep track of any accidents, no matter how small. Large facilities such as hospitals may have separate logs for certain departments or rooms, but the facility should keep a comprehensive log. Items to include in the log

  • Date
  • Time of day
  • Exact location (within facility)
  • Written description of accident - 3 sentences maximum
  • Medical procedure being performed, if any
  • Names of people involved
  • Hazardous materials released that could pose threat to humans or environment
  • Estimated amount of materials released
  • Authorities or first responders involved
  • Detailed description including context and narrative of events - This is needed in moderate or serious accidents, but can be skipped in the case of trivial accidents.
  • Disposition
  • Follow up, if needed

OSHA specifies an Exposure Incident as one in which an "eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties."

To comply with OSHA, the accident report must include the name of the patient the bodily fluid came from, unless there is a law or other good privacy reason to not do so.

Openness

Although they can be embarrassing to employees, spills should not cause a coverup or be secret. They should be seen as a learning opportunity. Research has found that nurses are more likely to report accidents than other medical professionals, but everyone should be willing to be upfront about mistakes without fear.