Working with glutaraldehyde.
Working with glutaraldehyde.
复制标题
使用戊二醛。
DOI：
10.1097/00000446-200106000-00030
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
K. Worthington
中科院分区：
文献类型：
--
作者：
K. Worthington
在过去的二十年中，侵入性和内窥镜手术的增长导致越来越多地使用高级消毒剂来“冷消毒”器械。甲醛是第一代消毒剂，由于担心其致癌性，卫生保健机构开始广泛使用戊二醛，因为人们认为它的毒性较小。不幸的是，这被证明是“风险转移”的一个例子，即选择一种新的化学品来取代已知的危害，即使这种新化学品对健康的影响尚未得到充分评估。研究和记录在案的工作场所经验表明，戊二醛并非没有自身的不良健康影响。它对皮肤、眼睛和呼吸系统有中等到强烈的刺激，皮肤接触可能引起皮肤过敏反应。此外，最近的国际研究有助于确认医院戊二醛暴露是职业性哮喘的一个原因。令人担忧的是，工人报告的暴露水平远低于以前认为的安全阈值。目前，没有联邦职业安全与健康管理局（OSHA）的标准来限制戊二醛的暴露，就像甲醛一样。OSHA危害沟通标准确实要求对所有接触危险化学品的员工进行适当的培训。OSHA正在降低包括戊二醛在内的四种化学品的允许暴露限值（PEL）。如果发布，PEL将对戊二醛的暴露施加更严格的限制。不幸的是，与标准相比，PEL的监管权力较小，因此不会详细说明雇主对暴露监测、危险警告、员工教育或医疗监测的要求。自20世纪80年代中期以来，国家职业安全与健康研究所（NIOSH）一直在调查卫生保健工作者因接触戊二醛而对健康产生不良影响的报告。他们的调查得出了若干结论：•不良症状似乎与接触浓度低于目前可接受的百万分之0.2的限值有关。•通过使用局部排气通风，可大大减少暴露，几乎消除症状。
Over the past two decades, the growth of invasive and endoscopic procedures has led to the increasing use of high-level disinfectants to “cold sterilize” instruments. In response to concerns about the carcinogenicity of formaldehyde—the first generation of these disinfectants—health care facilities began the widespread use of glutaraldehyde, which was thought to be less toxic. Unfortunately, this turned out to be an example of “risk shifting,” in which a new chemical is chosen to replace a known hazard, even though the health effects of the new chemical have not been fully evaluated. Research and documented workplace experience now indicate that glutaraldehyde is not without its own adverse health effects. It is a moderateto-strong irritant to the skin, eyes, and respiratory system, and dermal exposure may cause allergic skin reactions. In addition, recent international research has contributed to the recognition of glutaraldehyde exposure in hospitals as a cause of occupational asthma. Alarmingly, workers are reporting symptoms at exposure levels well below thresholds formerly thought to be safe.At present, there is no federal Occupational Safety and Health Administration (OSHA) standard to limit exposure to glutaraldehyde as there is for formaldehyde. The OSHA Hazard Communication Standard does require that proper training be given to all employees exposed to hazardous chemicals. OSHA is in the process of lowering the Permissible Exposure Limit (PEL) of four chemicals including glutaraldehyde. If published, the PEL would place stricter limits on exposure to glutaraldehyde. Unfortunately, a PEL carries less regulatory authority than a standard, and therefore would not spell out employer requirements for exposure monitoring, hazard warning, employee education, or medical monitoring. Since the mid-1980’s, the National Institute for Occupational Safety and Health (NIOSH) has been investigating reports of adverse health effects among health care workers as a result of working with glutaraldehyde. Their investigations lead to several conclusions:• Adverse symptoms appear to be associated with exposures at concentrations below the currently accepted limits of 0.2 parts per million.• Exposures can be dramatically reduced and symptoms virtually eliminated through the use of local exhaust ventilation.