An assessment of exposure to glutaraldehyde in hospitals: typical exposure levels and recommended control measures.

Abstract

An assessment of exposure to glutaraldehyde in cold sterilisation and x ray development processes was undertaken in 14 locations at six hospitals in south east England. The results obtained indicate that routine exposures of hospital workers to airborne concentrations of the compound are within the current United Kingdom occupational exposure limit of 0.7 mg m-3. There was the potential for skin contact in many of the activities observed and alternative sterilisation and disinfection procedures would have been more appropriate in some situations. Recommendations are made on reducing exposures as the current occupational exposure limit for this compound may not be appropriate.

Indoor Glutaraldehyde Levels in the Endoscope Disinfecting Room and Subjective Symptoms among Workers

“…Patients complaining of headache, dermal symptoms and respiratory symptoms caused by GA have been reported 1) .…”

Glutaraldehyde exposure and its occupational impact in the health care environment

“…For these reasons, continued vigilance is needed for the control and monitoring of workplace environments where GA is used and also for the ongoing assessment of health effects among exposed workers. (35,52) • Replace GA with alternative disinfectant such as hydrogen peroxide, peracetic acid-hydrogen peroxide (PAHP) or orthophthaldehyde (53, 54) Minimization • Skin contact and vapor inhalation should be minimized by using personal protective devices such as masks and gloves (33,36,52) • Reduce the number of people working in areas where GA is being used (35) • Spills of GA-containing liquids should be immediately cleaned up as soon as they occur (35,52) • Extraction fans should be installed, and preferably, push/pull ventilation systems (27,33,35,36,53) • All devices that contain GA solutions should be covered and sealed when not in use and only opened for the duration of use (33, 35, 36, 52) • Training and education for staff with emphasis on appropriate occupational hygiene techniques as mentioned above (33,35,52) …”

“…Therefore, appropriate PPE should consist of gowns and aprons, protective gloves made of an appropriate material (not latex), forearm protectors, eye protection with close fitting goggles, and personal respirators (33). Damaged gloves should be replaced immediately (52). Although the use of appropriate PPE would appear to be the obvious method for reducing exposure, it is not always practical.…”

“…This may be achieved by a combination of the strategies outlined in Table 5. Firstly, GA should be used only where other substances are inappropriate (52). Certain GA alternatives such as hydrogen peroxide, peracetic acidhydrogen peroxide (PAHP) and orthophthaldehyde, have been suggested for the cold disinfection of endoscopic equipment (53,54).…”

“…• Irritant contact dermatitis (41) • Operating theater nurses (22,23,30,36) • Chronic dermatitis (39) • Laboratory technicians (33, 38) • Systemic sensitization (45,50) • X-ray technicians (31,32,43,46) • Occupational asthma (45)(46)(47)(48)50) • Cleaners, veterinarians (39,40,43) rigidly followed in workplaces that use GA (33,52). The enclosure of GA in using containers which are long and deep, and that have close-fitting lids is important.…”