Glutaraldehyde exposure and its occupational impact in the health care environment

Environmental Health and Preventive Medicine

Volumn 11, Issue 1, 2006, Pages 3-10

  Smith, Derek R ^a   Wang, Rui Sheng ^a  

^a NATL INSTITUTE OF INDUSTRIAL HEALTH   (Japan)

Author keywords

Disinfection; Glutaraldehyde; Health care environment; Occupational exposure; Toxicology

Indexed keywords

GLUTARALDEHYDE; IRRITANT AGENT;

ASSISTED VENTILATION; CARCINOGENESIS; DISINFECTION; HEALTH CARE; HOSPITAL DEPARTMENT; HUMAN; INSTRUMENT STERILIZATION; LABORATORY PERSONNEL; NURSE; OCCUPATIONAL EXPOSURE; OPERATING ROOM; PROTECTIVE EQUIPMENT; RADIOLOGICAL TECHNOLOGIST; REVIEW; SENSITIZATION; TERATOGENESIS; WORKPLACE;

EID: 33645219319     PISSN: 1342078X     EISSN: 13474715     Source Type: Journal    
DOI: 10.1265/ehpm.11.3     Document Type: Review

References (62)

1. Russell AD, Hopwood D. The biological uses and importance of glutaraldehyde. Prog Med Chem. 1976;13:271-301.
2. Gorman SP, Scott EM, Russell AD. Antimicrobial activity, uses and mechanism of action of glutaraldehyde. J Appl Bacteriol. 1980;48:161-190.
3. Stonehill AA, Krop S, Borick PM. Buffered glutaraldehyde - A new chemical sterilizing solution. Am J Hosp Pharm. 1963;20:458-465.
4. O'Brien HA, Mitchell JD Jr, Haberman S, et al. The use of activated glutaraldehyde as a cold sterilizing agent for urological instruments. J Urol. 1966;95:429-435.
5. Haselhuhn DH, Brason FW, Borick PM. 'In use' study of buffered glutaraldehyde for cold sterilization of anesthesia equipment. Anesth Analg. 1967;46:468-474.
6. Beauchamp RO, St Clair MB, Fennell TR, et al. A critical review of the toxicology of glutaraldehyde. Crit Rev Toxicol. 1992;22:143-174.
7. Borick PM, Dondershine FH, Chandler VL. Alkalinized glutaraldehyde: A new anti-microbial agent. J Pharm Sci. 1964;53:1273-1275.
8. Gorman SP, Scott EM. The state of the glutaraldehyde molecule in relation to its biocidal activity. J Pharm Pharmacol. 1980;32:131-132.
9. Ballantyne B, Jordan SL. Toxicological, medical and industrial hygiene aspects of glutaraldehyde with particular reference to its biocidal use in cold sterilization procedures. J Appl Toxicol. 2001;21:131-151.
10. Gorman SP, Scott EM. Effect of inorganic cations on the biocidal and cellular activity of glutaraldehyde. J Appl Bacteriol. 1979;47:463-468.
11. Lippmann M (ed). Environmental Toxicants: Human Exposures and their Health Effects. New York: Van Nostrand Reinhold; 1992.
12. Besrat A, Polan CE, Henderson LM. Mammalian metabolism of glutaric acid. J Biol Chem. 1969;244:1461-1467.
13. Hemminki K, Suni R. Sites of reaction of glutaraldehyde and acetylaldehyde with nucleosides. Arch Toxicol. 1984;55:186-190.
14. Jolibois B, Guerbet M, Vassal S. Glutaraldehyde in hospital wastewater. Arch Environ Contam Toxicol. 2002;42:137-144.
15. Emmanuel E, Hanna K, Bazin C, et al. Fate of glutaraldehyde in hospital wastewater and combined effects of glutaraldehyde and surfactants on aquatic organisms. Environ Int. 2005;31:399-406.
16. Leung HW. Ecotoxicology of glutaraldehyde: Review of environmental fate and effects studies. Ecotoxicol Environ Saf. 2001;49:26-39.
17. Gad SC. A scheme for the prediction and ranking of relative potencies of dermal sensitizers based on data from several systems. J Appl Toxicol. 1988;8:361-368.
18. Ballantyne B, Myers RC. The acute toxicity and primary irritancy of glutaraldehyde solutions. Vet Hum Toxicol. 2001;43:193-202.
19. Vergnes JS, Ballantyne B. Genetic toxicology studies with glutaraldehyde. J Appl Toxicol. 2002;22:45-60.
20. Zeiger E, Gollapudi B, Spencer P. Genetic toxicity and carcinogenicity studies of glutaraldehyde - A review. Mut Res. 2005;589:136-151.
21. Avery JK. The good doctor - The bad result. J Tenn Med Assoc. 1985;78:440.
22. Hemminki K, Mutanen P, Saloniemi I, Niemi ML, Vainio H. Spontaneous abortions in hospital staff engaged in sterilising instruments with chemical agents. Br Med J. 1982;285:1461-1463.
23. Hemminki K, Kyyronen P, Lindbohm ML. Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health. 1985;39:141-147.
24. Ema M, Itami T, Kawasaki H. Teratological assessment of glutaraldehyde in rats by gastric intubation. Toxicol Lett. 1992;63:147-153.
25. Azadi S, Klink KJ, Meade BJ. Divergent immunological responses following glutaraldehyde exposure. Toxicol Appl Pharmacol. 2004;197:1-8.
26. Tkaczuk M, Pisaniello D, Crea J. Occupational exposure to glutaraldehyde in South Australia. J Occup Health Safety - Aust NZ. 1993;9:237-243.
27. Di Stefano F, Siriruttanapruk S, McCoach J, Sherwood Burge P. Glutaraldehyde: An occupational hazard in the hospital setting. Allergy. 1999;54:1105-1109.
28. Smith DR. Self-reported glutaraldehyde symptoms: Are they an accurate predictor of workplace risk? J Occup Health Safety - Aust NZ. 2001;17:287-293.
29. Ellett ML, Mikels CA, Fullhart JW. SGNA Endoscopic disinfectant survey. J Gastroenterol Nurs. 1995;18:2-10.
30. Smith DR. Airborne glutaraldehyde levels: Perceptions versus risk. J Occup Health Safety - Aust NZ. 2000;16:233-236.
31. Fisher AA. Reactions to glutaraldehyde with particular reference to radiologists and x-ray technicians. Cutis. 1981;28:113-122.
32. Dimich-Ward H, Wymer M, Kennedy S, et al. Excess of symptoms among radiographers. Am J Ind Med. 2003;43:132-141.
33. National Institute of Occupational Safety and Health (NIOSH). Glutaraldehyde: Occupational Hazards in Hospitals. NIOSH Publication 2001-115, Cincinnati; 2001.
34. Oie S, Kamiya A. Assessment of and intervention for the misuse of aldehyde disinfectants in Japan. Infect Control Hosp Epidemiol. 2002;23:98-99.
35. Romano-Woodward D. Safe use of glutaraldehyde. Nurs Stand. 2000;14:47-51.
36. Pisaniello DL, Gun RT, Tkaczuk MN, Nitshcke M, Crea J. Glutaraldehyde exposures and symptoms among endoscopy nurses in South Australia. Appl Occup Environ Hyg. 1997;12:171-177.
37. Sanderson KV, Cronin E. Glutaraldehyde and contact dermatitis. Br Med J. 1968;3:802.
38. Shaffer MP, Belsito DV. Allergic contact dermatitis from glutaraldehyde in health-care workers. Contact Dermatitis. 2000;43:150-156.
39. Nethercott JR, Holness DL, Page E. Occupational contact dermatitis due to glutaraldehyde in health care workers. Contact Dermatitis. 1988;18:193-196.
40. Fowler JF. Allergic contact dermatitis from glutaraldehyde exposure. J Occup Med. 1989;31:852-853.
41. Tam M, Freeman S. Occupational allergic contact dermatitis due to glutaraldehyde: A study of six cases due to Wavicide and Aldecyde. J Occup Health Safety - Aust NZ. 1989;5:487-491.
42. Vyas A, Pickering CAC, Oldham LA, et al. Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff. Occup Environ Med. 2000;57:752-759.
43. Smedley J, Inskip H, Wield G, Coggon D. Work related respiratory symptoms in radiographers. Occup Environ Med. 1996;53:450-454.
44. Smedley J, Cullinan P, Frew A, Newman-Taylor A, Coggon D. Work related respiratory symptoms in radiographers. Occup Environ Med. 1999;56:646.
45. Anees W, Robertson AS, Burge PS. Glutaraldehyde induced asthma in endoscopy nursing staff. Occup Environ Med. 2001;58:544.
46. Gannon PF, Bright P, Campbell M, O'Hickey SP, Burge PS. Occupational asthma due to glutaraldehyde and formaldehyde in endoscopy and x ray departments. Thorax. 1995;50:156-159.
47. Pałczyński C, Walusiak J, Ruta U, Górski P. Occupational asthma and rhinitis due to glutaraldehyde: Changes in nasal lavage fluid after specific inhalatory challenge test. Allergy. 2001;56:1186-1191.
48. Stenton SC, Beach JR, Dennis JH, Keaney NP, Hendrick DJ. Glutaraldehyde, asthma and work - A cautionary tale. Occup Med. 1994;44:95-98.
49. Waters A, Beach J, Abramson M. Symptoms and lung function in health care personnel exposed to glutaraldehyde. Am J Ind Med. 2003;43:196-203.
50. Quirce S, Gómez M, Bombín C, Sastre J. Glutaraldehyde- induced asthma. Allergy. 1999;54:1121-1122.
51. Curran AD, Burge PS, Wiley K. Clinical and immunologic evaluation of workers exposed to glutaraldehyde. Allergy. 1996;51:826-832.
52. Leinster P, Baum JM, Baxter PJ. An assessment of exposure to glutaraldehyde in hospitals: Typical exposure levels and recommended control measures. Br J Ind Med. 1993;50:107-111.
53. Rutala WA, Weber DJ. Disinfection of endoscopes: Review of new chemical sterilants used for high-level disinfection. Infect Control Hosp Epidemiol. 1999;20:69-76.
54. Cooke RPD, Goddard SV, Whymant-Morris A, Sherwood J, Chatterly R. An evaluation of Cidex OPA (0.55% orthophthalaldehyde) as an alternative to 2% glutaraldehyde for high-level disinfection of endoscopes. J Hosp Infect. 2003;54:226-231.
55. Rideout K, Teschke K, Dimich-Ward H, Kennedy SM. Considering risks to healthcare workers from glutaraldehyde alternatives in high-level disinfection. J Hosp Infect. 2005;59:4-11.
56. Teschke K, Chow Y, Brauer M, et al. Exposures and their control in radiographic film processing in British Columbia. Report to the Workers' Compensation Board of British Columbia, Vancouver; 2000.
57. Norbäck D. Skin and respiratory symptoms from exposure to alkaline glutaraldehyde in medical services. Scand J Work Environ Health. 1988;14:366-371.
58. Naidu V, Lam S, O'Donnell G. Typical glutaraldehyde vapour levels in endoscope disinfection units in New South Wales hospitals. J Occup Health Safety - Aust NZ. 1995;11:43-57.
59. Angelillo IF, Mazziotta A, Nicotera G. Nurses and hospital infection control: Knowledge, attitudes and behaviour of Italian operating theatre staff. J Hosp Infect. 1999;42:105-112.
60. Tashiro H, Oda S, Mori K. Significance of working environment improvement based on determination of source of harmful substance - Example of an endoscope syringe room using glutaraldehyde. J UOEH. 2004;26:99-109. (Article in Japanese)
61. Anonymous. Notification Corner. Occup Health J. 2005;28:81-84. (Article in Japanese)
62. Mwaniki DL, Guthua SW. Occupational exposure to glutaraldehyde in tropical climates. Lancet. 1992;340:1476-1477.