Section F: Emergency and Medical Procedures

Accidents to employees involving exposure to hazardous chemicals. Requirements of the OSHA laboratory Standard (29 CFR 1910.1450)

1.  Medical Procedures for Employees Exposed to Hazardous Chemicals

Medical Attention

• All employees who work with or are potentially exposed to hazardous chemicals must be given the opportunity to receive medical attention under the following circumstances:
• Whenever an employee develops signs or symptoms associated with a hazardous chemical to which the employee may have been exposed to in the laboratory.
• Where exposure monitoring reveals an exposure level routinely above the action level (or in the absence of an action level, the PEL) for an OSHA regulated substance for which there are exposure monitoring and medical surveillance requirements.
• Whenever an event takes place in the work area such as a spill, leak, explosion, or other occurrence resulting in the likelihood of the employee being exposed to hazardous chemicals.

Requirements and Responsibilities

• In the event that an employee was exposed or potentially exposed to a hazardous chemical, the chair must be immediately informed as to the situation. In the event that the chair is not available, the accident must be reported to the department's secretary or the safety officer for relay to the University safety officer. Accidents during evening classes must be reported to public safety -3333.
• All necessary medical examinations must be authorized by the University safety officer who will instruct the employee as to where to report for medical attention.

o University Environmental Health and Safety Office 323-2328 or (803) 242-9545

• In the event of a life threatening accident, call –3333 or 9-911.
• All necessary medical examinations must be performed by or under the direct supervision of a licensed physician and must be provided without cost to the employee, without loss of pay, and at a reasonable time and place.
• The chair is responsible for establishing the need for employee medical examination.

Information Provided to the Physician (Appendix J)

· The following information should be provided to the physician:

o The identify of the hazardous chemical to which the employee may have been exposed.

o The MSDS of the chemical

o A description of the conditions under which the exposure occurred

o A description of the signs and symptoms of exposure that the employee is experiencing, if any.

Physician's Report (Appendix K)

• A written report from the physician is required for any examination required under the chemical hygiene plan. The report from the examining physician should include the following:

· Any recommendation for further medical follow-up;

· The results of the medical examination and any associated testes;

· Any medical condition which may be revealed in the course of the examination that may place the employee at increased risk as a result of exposure to a hazardous chemical found in the workplace;

· A statement that the employee has been informed by the physician of results of the examination and any medical condition that may require further examination or treatment.

· The written opinion must not reveal specific findings of diagnoses unrelated to occupational exposure.

2.  Procedures for Employee Incidents Involving Bodily Injury

· All employees, including student assistants, who sustain an injury on the job, must adhere to the following guidelines.

o Notify the chair of the department immediately. If the chair is unavailable, the incident must be reported to the department's secretary for relay to the university's safety manager, ext. 2328 or (803) 242-9545.

o If someone's life is in danger, call –3333 immediately.

o Incidents during evening classes must be reported to public safety.

o An incident report form (see Appendix L) must be completed by the employee or in case of injury to a student employee; the report must be filled out by the student employee and the faculty/staff member in charge of the area in which the accident occurred. The completed form must be submitted to the chair.

· Accident report forms are available on line from the chemical hygiene plan. The completed form must be submitted to the chair.

3. Procedures for Student Incidents Involving Bodily Injury

· For all student incidents involving bodily injury, the employee in charge of the lab at the time of the incident must

o If someone's life is in danger, call –3333 immediately.

o Notify the chair of the department immediately. If the chair is unavailable, the incident must be reported to the department's secretary or the departments safety officer

o Incidents during evening classes must be reported to public safety.

o An incident report form (see Appendix M) must be completed by the employee and the student. The completed form must be submitted to the chair.

o For minor incidents, the student must go to Crawford Health Services

· Accident report forms are available on line from the chemical hygiene plan. The completed form must be submitted to the chair.

4.  Emergency Procedures in Case of Bodily Injury

University Employees¹

Very Serious^3	Call -3333
Serious^4	Call University Safety Manager –2328 or (803) 242-9545, and you will be instructed as to where to go
Minor^5	Minor first aid treatment

Non-working Students²

Very Serious^3	Call -3333
Serious^4	Call Public Safety -3333
Minor^5	Report to Crawford Health Services -2206

¹University employees include all faculty and staff employees, and also include student assistants who are performing their work duties at the time of the accident.
²Non-working students include all students not receiving any University pay for services rendered and all students who were not performing their work duties at the time of the accident.
³Very serious injury would involve an injury where the person is unconscious, seriously burned either by fire or chemicals, bleeding seriously, and/or ingested chemicals in any way.
⁴Serious injury would involve an injury where the person is in need of medical attention, but is able to walk.
⁵Minor injury would involve a minor cut, burn, etc.

5.  Guidelines for Employees for Dealing with Various Hazards in the Laboratory

If you are attempting to assist someone else who is injured, do not become injured yourself or you will no longer be of much help.

If you are attempting to assist someone covered in chemicals, wear safety goggles and gloves so that you too do not become injured.

Chemical Burns

Chemicals on the Skin in Confined Areas

· Immediately flush the area with cool water for at least 15 minutes. Remove all jewelry to facilitate removal of any residual material.

· Check the MSDS to see if any delayed effects should be expected.

· If a delayed reaction is noted (often the next day), call the University safety manager at –2328 (or (803) 242-9545) who will instruct you as to where to report for medical attention and carefully explain to medical personnel what chemicals were involved.

· If there is any doubt, call the university safety manager –2328 (or (803) 242-9545).

Chemicals Spilled over a Large Area of the Body

· Remove victim’s clothes.

o Remove victim’s shoes so that chemicals do not collect in the shoes.

o Rinse the area with large quantities of water for at least 15 minutes under a safety shower.

o Call public safety -3333 immediately.

Chemicals in the Eyes

· Get the victim to an eyewash station immediately, and rinse the eyes for at least 15 minutes.

· Eyelids have to forcibly opened to ensure effective washing behind the eyelid.

· Remove contact lenses as soon as possible so that the eyes can be thoroughly rinsed.

· All eye injuries must be treated by a doctor.

· Call public safety at –3333 immediately for help or call the university safety manager at -2328.

Fires

· A fire contained in a small vessel often can be suffocated, for example by placing a watch glass over its opening.

· If the fire is too large to be suffocated quickly, activate the fire alarm and notify everyone around you. Use the stairs when evacuating the building. Do not use the elevator during the evacuation.

· It is easy to underestimate a fire. Fires spend quickly. Never attempt to use a fire extinguisher unless you have been trained in its use. Locate yourself between the fire and the exit. Always be sure you can escape.

· If a person’s clothes are on fire, get them to stop, drop, and roll or lead them to a safety shower and douse them with water.

· Cover the victim with what ever is available (most labs have fire blankets), but leave the head uncovered. Do not cover a person with a fire blanket until the flames have been extinguished.

· Get medical attention immediately (public safety-3333 or 9-911).

Ingestion of Chemicals

· Identify the chemical ingested and call –3333 immediately.

· Wrap the injured person in a blanket to prevent shock.

Inhalation of Chemicals

· Evacuate the area and move the victim into fresh air.

· Call -3333

Wounds

Small cuts and scratches

· Cleanse area with soap and water preferably in a restroom and not in lab.

· Place a clean dressing over the wound.

· If you are assisting someone with a minor wound, wear safety glasses and disposable latex gloves, which are located in all first aid kits.

· If assisting a student, send them to Crawford Health Services.

Significant bleeding

· Call -3333 immediately

FIRST AID KITS

· There is a first aid kit located on each floor of the chemistry building. All accidents must be reported to the chair or the safety coordinator. The faculty or stuff member must inform the safety coordinator of all accidents so that a record of all accidents can be maintained and first aid kits can be restocked.

· No oral medication can be stocked in the first aid kits.

6.  Cleaning up Chemical Spills

Treat a chemical spill as an emergency situation and call public safety (-3333) immediately if there is an injured person, a fire or fire hazard exists, or there is significant fumes preventing anyone from getting close to the spill.

General Rules for Identifying and Cleaning up Chemical Spills

• Any student generating or finding a spill must inform a faculty member, the chemical hygiene officer, or lab personnel.
• Identify the chemical if possible.
• It is the responsibility of the faculty member, the chemical hygiene officer, the laboratory chemist, or the lab instructor to determine whether the spill is a simple spill or a complex spill.

Simple Spills

Simple spills are non-emergency situations. A spill can be identified as a simple spill if it meets the following criteria

1. Does not spread rapidly	The spilled chemical or toxic vapors are not spreading beyond the immediate area
2. Does not endanger people or property except by direct contact	A person has not been injured
	A fire is not present or an explosion has not occurred
	Flammable vapors and ignition sources are not present
	Toxic vapors or dust are not present
	The spilled chemical is not a strong oxidizer
	The spilled chemical is not air, water, or otherwise highly reactive
	The identify of the chemical is known
3. Does not endanger the environment	No risk of spilled chemical entering a sewer or contaminating soil

If a spill has been identified as a simple spill, it can safely be cleaned up if:

· A knowledgeable person can make an informed decision as to the safety and health hazards associated with the chemical and is comfortable doing it.

· The spill can be cleaned up with the material contained in the spill control kits.

· Personal protective equipment is available

· The cleanup can be completed in a normal work day

If a spill does not meet the above criteria, treat it as a complex spill and an emergency situation--Evacuate the area and call public safety -3333.

Complex spills are defined as:

• Causes personal injury or chemical exposure that requires medical attention
• Presents a fire hazard
• Requires the need for a breathing apparatus to handle the material involved

Procedures for Cleaning Up Simple Spills

· Shut off all possible ignition sources

· Notify your lab instructor

· Wear appropriate personal protective equipment

· Identify the spill

· Isolate the spill area. Evacuate the immediate area

· Locate the appropriate spill cleanup kit. Each laboratory should be equipped with spill cleanup kits. If not, get the appropriate kit from the chemistry storage room (SIMS 107)

· After the spilled chemical has been identified, obtain the proper absorbent material from the spill control kit. When using the Spill-X Chemical Spill Treatment Kits, you must make sure that the adsorbent is approved for the chemical that is being cleaned up. See Appendix N for a list of chemicals that can safely be cleaned up using the Spill-X Chemical Spill Treatment Kits.

• For acid spills, Spill-X-A
• For caustic spills, Spill-X-C
• For solvent spills, Spill-X-S

· Pour the spill agent around the perimeter of the spill first, and then continue to cover the spill with spill agent evenly working your way around to the center of the spill.

· Using the scraper provided carefully mix agent into the spill for the most complete reaction.

· If SPILL-X-A or SPILL-X-C was used, the spill residue must be tested for pH. See below for direction on testing the pH*.

· If SPILL-X-S agent was used, solvent is adsorbed onto the agent and the final spill residue should be dry and powdery.

· After spill residue cools, use scraper and pan to put the spill residue into a waste disposal bag and label with 

-Spill type such as "neutralized acid/base, pH = ____" or "adsorbed solvent: solvent name" 

-Date

· Wash utensils including gloves, if not disposable, with soap and water and put back in the spill control kit if still in good condition. If not, inform the chemical hygiene officer that those items need to be replaced.

· Decontaminate the spill area by mopping the area with a conventional cleaning agent

· Ventilating the spill area may be necessary.

· If the chemical that was spilled was a highly toxic substance, then the scraper and scoop that was used to pick up the spilled material should be discarded as waste.

*If SPILL-X-A or SPILL-X-C was used, the spill residue must be tested for pH.

· Place about 10 mL of the spill residue in a 150-mL beaker.

· Slowly add distilled water until the mixture volume reaches 100 mL. Note: Severe foaming and high heat generation is a sign of incomplete neutralization. Stir contents for about 3 minutes.

· Using a pH meter or the pH test strips provided in the kit, test the solution’s pH. The pH should be between 2.0 to 12.0. If the pH is unacceptable, mix more of the neutralizer into the spill and retest the pH. Repeat the procedure until an acceptable pH is reached.

· Record the final pH on the waste disposal bag.

Reference:  The ACS Guide for Chemical Spill Response Planning in Laboratories, the American Chemical Society, 1995.

7.  Mercury Spills

• Caution: Mercury is toxic, easily vaporizes, is absorbed directly through the skin and by inhalation, and threshold values of mercury and mercury vapors are very low

• Mercury spill kits are available in the stock room and chemistry electives lab.
• A mercury spill due to a broken thermometer can be safely cleaned up by a knowable person by:

• Inform others around you that there is a mercury spill to prevent personal injury and further contamination of the area, i.e. you do not want to step in it and tack the mercury all over the room.
• Personal protective equipment must be worn, i.e. safety glasses, gloves, and preferably a lab coat.
• Ventilate the contaminated area.
• Collect all visible mercury using either an aspirator bottle or a mercury collector, which is a jar with a screw type lid, which contains a foam pad for picking up the mercury. If using the mercury collector, press the foam pad firmly onto the spill to collect the mercury. Then screw the lid back onto the jar, which compresses the pad against a perforated plate inside the jar and releases the mercury into the bottom of the jar. The mercury in the jar must now be disposed of as waste. Do not leave the collected mercury in the jar.

• If the mercury spill occurred on a non-smooth surface, the following steps should be taken to ensure that all of the mercury gets cleaned up.

• Use the mercury absorber (the name will vary depending on the manufacturer such as MERCSORB powder, Hg Absorb powder, etc.) located in the kit.
• The different brands require different clean up instructions. Be sure to following the directions precisely.
• This procedure will convert elemental mercury to an amalgam, which stops dangerous mercury vapors from being emitted.
• Next, use the mercury indicator to ensure that all the mercury was cleaned up.
• Clean up all waste and dispose of in a waste container, which is clearly labeled as to its contents. Such as "Hazardous waste. Mercury" include the date
• The broken thermometer must be disposed of in a glass container that is properly labeled.

8. Reporting Unsafe Conditions

Any employee or student can and should report any condition or situation that may be a potential hazard. See Appendix O, Reporting Unsafe Conditions.