Spill Kits for OPA, Glutaraldehyde, Hydrogen Peroxide & Peracetic Acid

"It is important that all spills, including drips and splashes, be cleaned up immediately." *

According to OSHA and ANSI (Association of the Advancement of Medical Instrumentation) standards, high-level disinfectant spills must be contained and cleaned up immediately because they can cause a rapid increase of toxic fumes. The MSDS sheets for these high-level disinfectants reinforce this precaution.

OSHA and ANSI have published a series of guidelines surrounding the cleanup of these disinfectant spills. In 2006, OSHA published "Best Practices for the Safe Use of Glutaraldehyde in Health Care." While the document specifically addresses glutaraldehyde spills, the same safety measures should be applied to other commonly used aldehydes that are newer, such as OPA (ortho-phthalaldehyde).  The Instructions for Use for OPA and glutaraldehyde have almost the same safety engineering controls and ANSI provides similar safety guidelines dedicated to OPA.

Here's an outline of what OSHA advises for glutaraldehyde spills:

• A spill containment 'response team' must be created.
• The response team should consist of a safety committee representative, a physician (preferably an occupational health physician), the unit supervisor and any other appropriate personnel.
• A written spill containment plan must be created. Factors to consider: Concentration of the chemical, quantity spilled, size and temperature of the room in question, and type of ventilation in the room
• Spill kits minimize risk to those cleaning up the spill.
  • Drips, splashes and small spills should be cleaned up immediately. The disinfectant can be neutralized and cleaned with spill control kits that contain neutralizer and mats/wipes to absorb small spills. Personnel should wear protective equipment.
  • Large spills must be cleaned by a trained team, chemicals must be neutralized, and the entire area rinsed down thoroughly along with any equipment used during the cleanup process.

In 2005, ANSI published "Chemical Sterilization and High-Level Disinfection in Health Care Facilities." The document dedicates a section to OPA disinfectants and offers the following guidelines for OPA spills:

Personnel responsible for cleanup of OPA spills should have demonstrated competency in hazardous material spill cleanup procedures and should wear appropriate PPE, which should include at least:

• Splashproof mono goggles
• Polyvinylchloride, nitrile, or butyl rubber gloves
• Rubber boots or other shoe protection, and
• For spills larger than one gallon, an OSHA/NIOSH-approved reusable or disposable breathing mask equipped with an organic vapor cartridge filter.

To neutralize the OPA spill, ANSI suggests:

• A glycine powder should be sprinkled on the spill to neutralize the OPA
• The spilled disinfectant should be mopped into a plastic container
• The spill area should be mopped down with soap and water and then rinsed with large quantities of water
• The neutralized OPA should be poured down the drain followed by water

The MSDS for CIDEX OPA states:

Thoroughly blend the glycine into the spill using a mop or other tools. Allow 5 minutes contact for neutralization. Pick up and transfer to properly labeled containers.

The MSDS for Revital-Ox RESERT XL, a new hydrogen peroxide high-level disinfectant, advises:

Wear appropriate personal equipment, including safety goggles or glasses, protective gloves and appropriate protective clothing to minimize contact with skin. Contain and recover liquid when possible. Collect liquid in an appropriate container.

Glute Out neutralizer is a fast-acting glycine powder that is sprinkled over an OPA or glutaraldehyde spill.

Key Takeaways:

• OPA and glutaraldehyde should be treated with the same safety precautions
• Create a spill containment plan and train staff
• Neutralize disinfectant and thoroughly clean area
• Provide proper spill kit equipment to protect staff
• New spill kits developed for hydrogen peroxide and peracetic acid

*Chemical Sterilization and High-Level Disinfection in Health Care Facilities. ANSI/AMMI ST58:2005, pg 60