Glutaraldehyde: an occupational hazard in the hospital setting
Glutaraldehyde: an occupational hazard in the hospital setting
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DOI：
10.1034/j.1398-9995.1999.00239.x
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发表时间：
1999-10-01
期刊：
影响因子：
12.4
通讯作者：
Burge, PS
中科院分区：
文献类型：
--
作者：
Di Stefano, F;Siriruttanapruk, S;Burge, PS
背景资料：我们报告了一系列的24名医护人员的呼吸道症状提示职业性哮喘由于戊二醛exposed.Methods：哮喘症状的历史进行了调查，呼气峰流速（PEFR）监测，并在8个科目，特异性支气管激发试验（SBPT）作为参考标准，用于诊断职业性哮喘。在SEPT期间，监测挑战室中的戊二醛水平。在内窥镜检查和手术室护士PEFR监测期间，从至少一次采集的空气样本中测量戊二醛的工作环境水平。用戊二醛修饰的蛋白质测定特异性IgE抗体。结果：在8名接受SEPT的工人中，确诊为职业性哮喘的阳性反应（迟发反应5例，双重反应3例）。挑战试验期间观察到的戊二醛平均水平为0.075 mg/m（3）（范围0.065-0.084 mg/m（3））。在16名剩余工人中的13名中，连续PEFR监测显示出与工作相关的影响。在三名工人中，没有职业性哮喘的生理确认。从工作场所采集的空气样本中的戊二醛水平如下：个人短期样本（平均值0.208 mg/m（3）;中位数0.14 mg/m（3）;范围0.06-0.84 mg/m（3）），个人长期样本（平均值0.071 mg/m（3）;中位数0.07 mg/m（3）;范围0.003-0.28 mg/m（3））。根据0.88%RAST结合的临界值，在7例患者（29.1%）中对戊二醛修饰的蛋白质的特异性IgE抗体测量呈阳性。对常见环境过敏原和吸烟的特应性的存在与特异性IgE阳性无关（P>0.05; Fisher精确检验）。结论：我们的报告表明戊二醛作为一种职业危害在暴露的卫生保健工作者中的重要性。在工作场所进行干预，对处理这种化学品的人员进行培训，以及进行准确的健康监测，可能会降低因戊二醛而发生职业性哮喘的风险。
Background: We report a series of 24 health-care workers with respiratory symptoms suggestive of occupational asthma due to glutaraldehyde exposure.Methods: The history of asthmatic symptoms was investigated with peak expiratory flow rate (PEFR) monitoring, and in eight of the subjects, the specific bronchial provocation test (SBPT) was applied as reference standard for diagnosis of occupational asthma. Levels of glutaraldehyde were monitored in the challenge chamber during the SEPT. Work environmental levels of glutaraldehyde were measured from air samples collected at least once during the PEFR monitoring of endoscopy and theatre nurses. Specific IgE antibodies to glutaraldehyde were measured with a series of glutaraldehyde modified proteins.Results:ln the eight workers who underwent SEPT, the diagnosis of occupational asthma was confirmed by a positive reaction (late and dual reaction in five and in three subjects, respectively). The mean level of glutaraldehyde observed during the challenge tests was 0.075 mg/m(3) (range 0.065-0.084 mg/m(3)). In 13 out of the 16 remaining workers, the serial PEFR monitoring showed a work-related effect. In three workers, there was no physiological confirmation of occupational asthma. Levels of glutaraldehyde from the air samples collected in the workplace were as follows: personal short-term samples (mean 0.208 mg/m(3); median 0.14 mg/m(3); range 0.06-0.84 mg/m(3)), per sonal long-term samples (mean 0.071 mg/m(3); median 0.07 mg/m(3); range 0.003-0.28 mg/m(3)). Measurements of specific IgE antibodies to glutaraldehyde-modified proteins were positive in seven patients (29.1%) according to a cutoff value of 0.88% RAST binding. The presence of atopy to common environmental allergens and smoking was not associated with specific IgE positivity (P>0.05; Fisher's exact test).Conclusions: Our report indicates the importance of glutaraldehyde as an occupational hazard among exposed health-care workers. Intervention in the workplace, training of personnel handling this chemical, and accurate health surveillance may reduce the risk of developing occupational asthma due to glutaraldehyde.