Hospital Healthcare Workers at Risk for Glutaraldehyde Exposure

Glutaraldehyde is a toxic chemical that is used as a cold sterilant to disinfect and clean heat-sensitive medical, surgical and dental equipment.

It is found in products such as Cidex, Aldesen, Hospex, Sporicidin, Omnicide, Matricide, Wavicide and others. Glutaraldehyde is used in a limited number of applications, rather than as a general disinfectant. Specific applications include use as a disinfecting agent for respiratory therapy equipment, bronchoscopes, physical therapy whirlpool tubs, surgical instruments, anesthesia equipment parts, x-ray tabletops, dialyzers, and dialysis treatment equipment.

This puts hospital central supply workers at risk. Glutaraldehyde is also used as a tissue fixative in histology and pathology labs and as a hardening agent in the development of x-rays.

Health effects of glutaraldehyde exposure include:

Short term (acute) effects: Contact with glutaraldehyde liquid and vapor can severely irritate the eyes, and at higher concentrations burns the skin. Breathing glutaraldehyde can irritate the nose, throat, and respiratory tract, causing coughing and wheezing, nausea, headaches, drowsiness, nosebleeds, and dizziness.

Long-term (chronic) effects: Glutaraldehyde is a sensitizer. This means some workers will become very sensitive to glutaraldehyde and have strong reactions if they are exposed to even small amounts. Workers may get sudden asthma attacks with difficult breathing, wheezing, coughing, and tightness in the chest. Prolonged exposure can cause a skin allergy and chronic eczema, and afterwards, exposure to small amounts produces severe itching and skin rashes. It has been implicated as a possible cause of occupational asthma.

The National Institute for Occupational Safety and Health (NIOSH) suggests ways in which health care workers may be exposed to glutaraldehyde including:

1. Hospital staff who work in areas with a cold sterilizing procedure that uses glutaraldehyde (e.g., gastroenterology or cardiology departments).

2. Hospital staff who work in operating rooms, dialysis departments, endoscopy units, and intensive care units, where glutaraldehyde formulations are used ininfection control procedures.

3. Central Supply workers who use glutaraldehyde as a sterilant.

4. Research Technicians, researchers, and pharmacy personnel who either prepare the alkaline solutions or fix tissues in histology and pathology labs.

5. Laboratory workers who sterilize bench tops with glutaraldehyde solutions.

6. Workers who develop x-rays.