The Effect of Work Practices on Personal Exposure to Glutaraldehyde among Health Care Workers

Abstract

Glutaraldehyde is a potential sensitizer and has been implicated in the literature as a cause of respiratory irritation and asthma among health care workers. In order to evaluate the effect of work practices and general ventilation system on employees' peak exposure to glutaraldehyde, 42 breathing zone personal air samples were taken in five hospitals. In addition, work practices were observed and recorded during the course of sampling and were classified into three categories. Presence of local or general ventilation system, air change per hour, and quantity of glutaraldehyde used were also recorded. Geometric mean concentration of all samples was 0.025 ppm (GSD=3.05). Statistical analysis indicated that work practice was the most important factor affecting the level of exposure to glutaraldehyde. In locations where "poor" or "unsafe" work practices were employed, the geometric mean concentrations were much higher (GM=0.05, GSD=2.11 and GM 0.08, GSD=1.52, respectively). The result has indicated higher prevalence of headache and itchy eyes among employees who worked where unsafe work practices were observed. Employing proper work practices can significantly reduce exposure to glutaraldehyde among health care workers. It has been recently proposed that the current occupational exposure limit of 0.2 ppm shall be reduced to either 0.1 or 0.05 ppm in the province of Québec (Canada). In this case, it is likely that concentration levels higher than these levels be experienced in some workplaces. Therefore, it is imperative that employers initiate necessary corrective action immediately.

Exposure of health workers in primary health care to glutaraldehyde

“…The excellent properties of glutaraldehyde makes it the first choice in health centres in terms of considerations for health and safety in the workplace. Many papers illustrated and described the hazards of glutaraldehyde to the exposed health workers in the hospital environment [17,18]. However there is very little evidence in the primary care setting even though it is more utilized by the population.…”

“…Factors that contribute to exposure of glutaraldehyde are inadequate and unsafe working practices [17], insufficient ventilation [18], and the failure to use goggles, protective clothing and gloves [19]. …”

“…There is scientific evidence that shows glutaraldehyde air concentration in the workplace, namely hospitals: measurements in the endoscopy department showed a mean concentration of 3,7 ± 7,4 mg/m 3 [20]; in surgical theatres values above the limit of 0.05 ppm [17]; or in the Xray services an average of 0.0018 mg/m 3 , levels in the darkroom were five times over the legal limit values [21]. …”

Adverse Health Effects of Glutaraldehyde and Its Relation to Workplace Safety Measures and Work Practices of Health Care Workers

“…Reported adverse health effects related to short term exposure to glutaraldehyde are due to its irritant effect (Cohen and Patton, 2006). They include irritation to the nose, eye and pharynx leading to sore throat, sneezing, cough, headache, nausea, rash and redness of skin (Takigawa and Endo, 2006;Nayebzadeh, 2007). Moreover, a sensitizing effect may occur due to long term exposure to glutaraldehyde (Waters et al, 2003).…”

“…work practices have a significant effect on reducing GA exposure level and its adverse health effects (Nayebzadeh, 2007). Health studies of workers exposed to glutaraldehyde have shown that good work practices prevent allergic skin reactions (OSHA, 2006) and considered as a primary prevention to reduce occupational asthma (Heederik et al, 2012).…”