Laboratory Emergency Response & Incident Reporting Guide. Occupational & Environmental Safety Office Duke University Health System.

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Laboratory Emergency Response & Incident Reporting Guide Occupational & Environmental Safety Office Duke University Health System Quick Reference Revised 2016 Blood/Body Fluid Hotline From a Duke phone... 115 From a non-duke phone... 919-684-8115 Duke Police/Security Campus phone... 911 Non-Campus phones... 919-684-2444 Employee Occupational Health & Wellness... 919-684-3136 Poison Control... 1-800-222-1222 Corporate Risk Management... 919-684-6226 Workers Compensation... 919-684-6693 Report work-related injuries & illnesses: https://forms.hr.duke.edu/workcomp/ EMERGENCY 911

Minor Spill Involving Blood or Body Fluids Wear disposable gloves. Cover spill with paper towel or other absorbent materials. Clean area of all visible fluids with detergent (soap/water). Decontaminate area with 1:10 dilution of bleach: water if the surface is porous and 1:100 if the surface is hard & smooth; or use an approved hospital disinfectant. Place all disposable materials into a plastic leak-proof bag or medical waste container and dispose of appropriately. Biological Spill on Body Remove contaminated clothing. Wash area with soap and water for 1 minute. For eye exposures, flood eyes with water from eyewash station. Obtain medical attention, if necessary. Report incident to supervisor and complete HR work-related injury/illness report or other appropriate incident report. Call Blood and Body Fluid Hotline (115 or 919-684-8115) Spill Involving Concentrated Microorganisms Requiring Biosafety Level 1 or 2 (BSL1 or BSL2) Containment (E. coli, Staphylococcus, bloodborne pathogens, adenoviruses, organisms containing recombinant DNA, etc.) Alert people in immediate area of spill. Put on protective equipment. Cover spill with paper towel or other absorbent materials. Carefully pour a freshly prepared 1:10 dilution of bleach around the edges of the spill and then into the spill. Avoid splashing. Allow a 20 minute contact period. Wipe up the spill using paper towels and working from the outer edges into the center. Clean spill area with fresh towels soaked in disinfectant. Place towels in a plastic bag and decontaminate in an autoclave or medical waste container. Dispose of as regular trash after autoclaving according to the Medical Waste Policy. Spill Involving Concentrated Microorganisms Requiring Biosafety Level 3 (BSL3) Containment (Mycobacterium tuberculosis (TB) cultures) Attend to injured or contaminated persons and remove them from exposure. Alert people in immediate area to evacuate. Close doors to affected area and do not enter area for at least 1 hour. Have a person knowledgeable of the incident and area assist in proper clean-up. Wearing gowns, gloves, appropriate respirator (N95 or PAPR with HEPA filters) and shoe covers, clean up spills as indicated for Biosafety Level 1 or 2 organisms. Exposures to human blood or body fluids should be reported immediately to the Employee Blood and Body Fluid Exposure Hotline by dialing 115 or 919-684-8115 if off-campus. Always practice Universal Precautions when handling human blood or body fluids. OESO Biological Safety Division... 919-684-8822 BIOLOGICAL

Minor Chemical Spills Alert people in the immediate area of spill. Avoid breathing vapors from spill. Turn off ignition and heat sources if spilled material is flammable. Put on appropriate protective equipment, such as safety goggles, suitable gloves, and long sleeved lab coat. Confine spill to small area. Use appropriate kit to neutralize and absorb organic acids and bases. Use appropriate kit or spill pads. Collect residue, place in appropriate container and dispose as chemical waste (call 919-684-2794 for waste collection). Clean spill area with water. Chemical Spill on Body Flood exposed area with running water from faucet or safety shower for at least 15 minutes. Remove all contaminated clothing and shoes. Obtain medical attention, if necessary. Report incident to supervisor and complete HR work-related injury/illness report or other appropriate incident report. Hazardous Material Splashed in the Eye Immediately rinse eyeball and inner surface of eyelid with water continuously for 15 minutes. Forcibly hold eye open to effectively wash behind eyelids. Obtain medical attention. Report incident to supervisor and complete HR work-related injury/illness report or other appropriate incident report. Major Chemical Spills Alert people in the area to evacuate. Turn off ignition and heat sources if spilled material is flammable. On Campus: Call 911 from a campus phone or 919-684-2444 from a cell phone. Off campus: Call 911. Attend to injured or contaminated persons and remove them from exposure. Have person knowledgeable of area assist emergency personnel. OESO Environmental Programs... 919-684-2794 OESO Occupational Hygiene & Safety... 919-684-5996 CHEMICAL

Fire Procedures Use the RACE procedure: Remove persons in danger. Exit through stairwell, do not use elevator. Activate alarm (Code Red) & dial 911. Close doors and windows. Extinguish fire. Have person knowledgeable of incident and area assist emergency personnel. To extinguish the fire, use the correct fire extinguisher and the PASS procedure: Pull the pin Aim at the base of the fire Squeeze the handle Sweep from side to side Always maintain accessible exit. Avoid smoke or fumes. Pull the Pin, Call it In. Clothing on Fire STOP, DROP and ROLL around on the floor to smother flames or drench with water if safety shower is immediately available. Report incident to supervisor. Location of Evacuation Route Map Location of a safe area Location of exit stairwell Location of Fire extinguisher Always report any fire no matter how small... 919-684-2444 Fire Emergency... 911 If calling from a cell phone, advise the Durham dispatcher that you are calling from Duke so they can coordinate the response with Duke Police. FIRE - CODE RED

Musculoskeletal Disorders (MSDs) Develop over time and can take a long time to heal Can be quite painful and reduce overall effectiveness and efficiency Occur in any part of the body A variety of risk factors (personal and work-related) can increase the risk of developing a MSD Reducing exposure to these risk factors may reduce the likelihood of developing injury The sooner a MSD is identified, the better the chances of quickly recovering or preventing possible progression of the problem MSD Signs and Symptoms Inflammation Pain Redness Swelling Numbness Tingling Loss of Function Deformity Seek medical treatment if you experience any of these MSD signs or symptoms. For an ergonomic assessment of your work area, contact the Ergonomics Division. Ergonomics: Increases comfort and safety Increases productivity and job satisfaction Prevents/reduces the risk of MSDs OESO Ergonomics Division... 919-668-ERGO(3746) Visitor Injuries/Illnesses Respond to injured. Report incident: Duke Police... 919-684-2444 Corporate Risk Management... 919-684-6226 Employee Work-Related Injuries/Illnesses If emergency care is needed, go to a DUHS Emergency Department or call 911. All work-related injuries/illnesses regardless of the severity must be reported to your supervisor. Fill out a Report of Occupational Injury/Illness Form within 24 hours. You can find this form on the Duke Human Resources Website. Obtain care for non-life threatening injuries through EOHW. When EOHW is closed, employees may seek treatment at Duke Urgent Care or a DUHS Emergency Room. All work-related exposures to blood or body fluids are to be reported immediately through the Employee Blood/Body Fluid Hotline by dialing 115 and off-campus by dialing 919-684-8115. Employee Occupational Health & Wellness... 919-684-3136 Workers Compensation... 919-684-6693 Animal Bites/Scratches Wash affected area thoroughly with soap and water 3-5 minutes and then cover with a bandage or sterile dressing. Flush eyes as appropriate. Report injury to supervisor immediately. Fill out a Report of Occupational Injury/Illness Form within 24 hours. Warning: Bites, scratches or exposure to body fluids received from non-human primates can be extremely serious. Please seek immediate attention from Employee Occupational Health & Wellness. If animal bites/scratches or exposure to body fluids occurs from any non-rodent species, please notify the Division of Laboratory Animal Resources. Division of Laboratory Animal Resources.... 919-684-2797 PERSONAL INJURY

Minor Radiological Spills Alert people in immediate area of spill. Notify Radiation Safety (919-684-2194). Wear protective equipment, including safety goggles, disposable gloves, shoe covers and long sleeved lab coat. Place absorbent paper towels over liquid spills. Place towels dampened with water over solid materials. Use forceps to place towels in plastic bag. Dispose of in a low-level, radioactive waste container. Monitor area, hands and shoes for any contamination with an appropriate survey meter or method. Repeat clean-up until contamination is no longer detected. Radiological Spill on Body Remove contaminated clothing. Rinse exposed area thoroughly with water. Obtain medical attention, if necessary. Report incident to supervisor and Radiation Safety Office and complete a work-related injury/illness report as indicated under Personal Injury. Major Radiological Spills Attend to injured or contaminated persons and remove them from spill area. Alert people in the area to evacuate. Have potentially contaminated personnel stay in one area until they have been monitored and shown free of contamination. Call 911 from a campus phone or 919-684-2444 from a cell phone and indicate a radiation spill occurred. Duke Police will notify Radiation Safety. Close doors and prevent entrance into affected area. Have person knowledgeable of incident and area assist emergency personnel. Document names of persons potentially contaminated. Laser Exposure Seek medical attention immediately. Report the incident to supervisor and Radiation Safety Office. Complete a work-related injury/illness report as indicated under Personal Injury. OESO Radiation Safety Division... 919-684-2194 After hours call Duke Police... 919-684-2444 RADIOLOGICAL

Unsafe Work Conditions Report unsafe work conditions to your supervisor or manager. If input from the Occupational and Environmental Safety Office (OESO) is needed, call 919-684-2794 Security Incidents To Report Theft Harassing Telephone Calls Assault Personal Threats, including threats via social media Suspicious Activity Weapon Possession Disorderly Conduct Any crime Against Person or Property Dial 911 from a campus phone or contact Duke Police at 919-684-2444. Requests for Protective Escorts should be made through Duke Police at 919-684-2444. SAFETY/SECURITY

Building Utility/Maintenance Problems or Failures The Duke University Facilities Management Department (FMD) and Medical Center Engineering and Operations Department are service departments with the responsibility to provide systems and building support including: Electrical Problems Fire and other Alarm Systems Heating / Air Conditioning General / Carpentry Plumbing Problems Elevator Problems Medical Center Engineering and Operations... 919-684-3232 24 hours a day / 7 days a week University Facilities Management... 919-684-2122 UTILITIES