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Tuberculosis Laboratory Biosafety Manual. Geneva: World Health Organization; 2012.

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Tuberculosis Laboratory Biosafety Manual.

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8Plans for emergency preparedness and response

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.

8.1. Emergency preparedness plan

The plan should provide operational procedures for:

  • responses to natural disasters, such as fires, floods, earthquakes or explosions
  • risk assessments associated with any new or revised procedure
  • managing exposures and decontamination
  • emergency evacuation of people from the premises
  • emergency medical treatment of exposed and injured persons
  • medical surveillance of persons exposed to an incident
  • clinical management of persons exposed to an incident
  • epidemiological investigation
  • continuing operations after an incident.

In developing this plan the following items should be considered for inclusion:

  1. location of high-risk areas, such as laboratories and storage areas
  2. identification of at-risk personnel and populations
  3. identification of procedures according to the level of risk
  4. identification of responsible personnel and their duties, such as the biosafety officer, safety personnel, local health authority, clinicians, microbiologists, veterinarians, epidemiologists, fire services and police services
  5. treatment and follow-up facilities that can receive exposed or infected persons
  6. transport for exposed or infected persons
  7. how emergency equipment will be provided, such as protective clothing, disinfectants, chemical and biological spill kits, decontamination equipment and supplies.

8.2. Emergency response procedures for TB laboratories

8.2.1. Infectious spills (outside a biological safety cabinet)

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.

Signs should be posted indicating that entry is forbidden during the clean-up procedure. Appropriate protective clothing and respiratory protection MUST be worn.

The following spill clean-up procedure should be used.

  1. Put on gloves, a protective laboratory gown and respirator.
  2. Re-enter the affected area.
  3. Cover the spill with cloth or paper towels to contain it.
  4. Pour an appropriate disinfectant over the paper towels and the immediate surrounding area (generally, 5% bleach solutions are appropriate).
  5. Apply disinfectant concentrically beginning at the outer margin of the spill and working towards the centre.
  6. Allow sufficient time for the disinfectant to act before clearing away any material for disposal. If broken glass or other sharps are involved, use a dustpan or a piece of stiff cardboard to collect the material and place it in a puncture-resistant container for disposal.
  7. Place other contaminated material in a sealed bag for appropriate disposal.
  8. Clean and disinfect the area of the spill.

Anyone who was exposed to the spill should be referred for medical advice; a record should be kept of the incident.

8.2.2. Infectious spills (contained within a biological safety cabinet)

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.
  5. Any equipment or reusable material (for example, centrifuge buckets) that has been splashed should be cleaned with the same disinfectant.
  6. Electrical equipment should be checked carefully before it is used; check the integrity of circuit breakers and earth-fault interrupters.
  7. Collect other contaminated material in a sealed bag for appropriate disposal.

8.2.3. Breakage of tubes inside sealed buckets (safety cups)

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.

8.3. Spill clean-up kit

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

  • Hypochlorite solution stored in an opaque bottlea (or another suitable disinfectant)
  • Respirators (1 box)
  • Gloves (1 box )
  • Laboratory gowns (4-6 disposable gowns)
  • Dustpan and brush (for disposal if necessary)
  • Chloramine tablets ( 10 tablets)
  • Paper towels
  • Soap
  • Sharps container
  • Biohazard bags
  • Goggles ( 2pairs)



Hypochlorite in solution has a limited shelf life. For a large spill, it may be better to prepare the disinfectant solution at the time of clean up.

Copyright © World Health Organization 2012.

All rights reserved. Publications of the World Health Organization are available on the WHO web site ( or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (

Bookshelf ID: NBK179142


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